MEDICARE: INSTITUTE FOR BONE & JOINT DISORDERS PC

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	174400000X	Specialist

General Provider Information

NPI Number	:	1578560900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSTITUTE FOR BONE & JOINT DISORDERS PC

Provider Business Mailing Address
First Line	:	PO BOX 52507
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85072-2507
Country	:	US
Telephone Number	:	602-778-0900
Fax Number	:	602-778-6606

Provider Business Practice Location Address
First Line	:	2222 E HIGHLAND AVE
Second Line	:	SUITE 130, 400
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4872
Country	:	US
Telephone Number	:	602-778-0900
Fax Number	:	602-778-6606

Authorized Official
Title or Position	:	DIRECTOR OF PHYSICAL THERAPY
Name	:	CHANDRIKA J LOTWALA
Credential	:	DPT
Telephone Number	:	602-778-0900

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	08/22/2020

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