MEDICARE: SPINESCOTTSDALE, 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
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1427283936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPINESCOTTSDALE, PLLC

Provider Business Mailing Address
First Line	:	10277 N 92ND ST STE 103
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4564
Country	:	US
Telephone Number	:	480-584-3334
Fax Number	:	480-272-9369

Provider Business Practice Location Address
First Line	:	10277 N 92ND ST STE 103
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4564
Country	:	US
Telephone Number	:	480-584-3334
Fax Number	:	480-272-9369

Authorized Official
Title or Position	:	BUSINESS ADMINISTRATOR
Name	:	EMILY GLORIA SULLIVAN
Credential	:
Telephone Number	:	480-584-3334

Provider Enumeration Date	:	05/28/2009
Last Update Date	:	05/19/2022

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Directions to “SPINESCOTTSDALE, PLLC ” Practice Location

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