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NPI Code Detail

MEDICARE: PALADINO PHYSICAL THERAPY PLLC

MEDICARE: PALADINO PHYSICAL THERAPY PLLC
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
12251X0800XOrthopedic Physical Therapist6812AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11003848680OTHERAZAZ

General Provider Information

NPI Number : 1245749399
Entity Type Code : Organization
Provider Name (Legal Business Name) : PALADINO PHYSICAL THERAPY PLLC
Provider Business Mailing Address
First Line : 12861 W PALO BREA LN
Second Line :
City : PEORIA
State : AZ
Zip : 85383-4419
Country : US
Telephone Number : 623-824-2785
Fax Number : 623-518-2997
Provider Business Practice Location Address
First Line : 9049 W LAKE PLEASANT PKWY
Second Line :
City : PEORIA
State : AZ
Zip : 85382-8361
Country : US
Telephone Number : 623-824-2785
Fax Number : 623-518-2997
Authorized Official
Title or Position : CEO
Name : MR. JASON B PALADINO
Credential : PT, ATC
Telephone Number : 623-824-2785
Provider Enumeration Date : 09/20/2017
Last Update Date : 03/17/2018

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