MEDICARE: DR. RHENAND MENDOZA 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-033337	AZ

General Provider Information

NPI Number	:	1427482991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RHENAND MENDOZA PT, DPT

Provider Business Mailing Address
First Line	:	1510 E WAGON WHEEL LN STE 110
Second Line	:
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86426-6698
Country	:	US
Telephone Number	:	928-248-0444
Fax Number	:	928-248-0443

Provider Business Practice Location Address
First Line	:	1510 E WAGON WHEEL LN STE 110
Second Line	:
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86426-6698
Country	:	US
Telephone Number	:	928-248-0444
Fax Number	:	928-248-0443

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

Provider Enumeration Date	:	09/03/2013
Last Update Date	:	04/07/2026

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