MEDICARE: FADI FRED ABOULHOSN PT

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	9945	AZ

General Provider Information

NPI Number	:	1376893115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FADI FRED ABOULHOSN PT

Provider Business Mailing Address
First Line	:	PO BOX 5924
Second Line	:
City	:	CAREFREE
State	:	AZ
Zip	:	85377-5924
Country	:	US
Telephone Number	:	480-488-9095
Fax Number	:	480-488-2862

Provider Business Practice Location Address
First Line	:	7208 E. CAVE CREEK RD
Second Line	:	SUITE H
City	:	CAREFREE
State	:	AZ
Zip	:	85377-5924
Country	:	US
Telephone Number	:	480-488-9095
Fax Number	:	480-488-2862

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

Provider Enumeration Date	:	09/19/2012
Last Update Date	:	09/19/2012

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Directions to “ FADI FRED ABOULHOSN PT” Practice Location

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