MEDICARE: CORINNE MARGARET OLIPHANT 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-034544	AZ

General Provider Information

NPI Number	:	1306703558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORINNE MARGARET OLIPHANT DPT

Provider Business Mailing Address
First Line	:	1844 E BASELINE RD STE C5
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-1506
Country	:	US
Telephone Number	:	480-833-1005
Fax Number	:	480-833-1312

Provider Business Practice Location Address
First Line	:	5761 E BROWN RD STE 19
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85205-4449
Country	:	US
Telephone Number	:	480-719-8080
Fax Number	:	480-981-8595

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

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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