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NPI Code Detail

MEDICARE: MR. MARK ANDREW STAPEL PTA

MEDICARE:  MR. MARK ANDREW STAPEL  PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant7927AAZ

General Provider Information

NPI Number : 1215472139
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK ANDREW STAPEL PTA
Provider Business Mailing Address
First Line : 4635 N 14TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-4016
Country : US
Telephone Number : 602-264-9039
Fax Number :
Provider Business Practice Location Address
First Line : 4635 N 14TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-4016
Country : US
Telephone Number : 602-264-9039
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2017
Last Update Date : 01/01/2017

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Directions to “ MR. MARK ANDREW STAPEL PTA” Practice Location

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