MEDICARE: CHARITY STOLTZ PT, DPT

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
1	225100000X	Physical Therapist	LPT-034244	AZ

General Provider Information

NPI Number	:	1265324370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARITY STOLTZ PT, DPT

Provider Business Mailing Address
First Line	:	5017 E WASHINGTON ST STE 107A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85034-2033
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5017 E WASHINGTON ST STE 107A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85034-2033
Country	:	US
Telephone Number	:	602-277-1073
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2025
Last Update Date	:	12/10/2025

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