MEDICARE: INNERVATION PHYSICAL THERAPY LLC

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

General Provider Information

NPI Number	:	1326914110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNERVATION PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	264 W 32ND ST
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-8152
Country	:	US
Telephone Number	:	928-920-8735
Fax Number	:

Provider Business Practice Location Address
First Line	:	264 W 32ND ST
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-8152
Country	:	US
Telephone Number	:	928-920-8735
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST/OWNER
Name	:	DR. OSCAR ESQUEDA JR.
Credential	:	PT, DPT
Telephone Number	:	928-446-4463

Provider Enumeration Date	:	10/16/2025
Last Update Date	:	10/16/2025

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