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NPI Code Detail

MEDICARE: TANYA M HENRY PT

MEDICARE: TANYA M HENRY 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
1225100000XPhysical TherapistLPT-012793AZ

General Provider Information

NPI Number : 1629115936
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANYA M HENRY PT
Provider Business Mailing Address
First Line : 15836 S 9TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85048-1929
Country : US
Telephone Number : 214-457-8166
Fax Number :
Provider Business Practice Location Address
First Line : 60 E RIO SALADO PKWY STE 900
Second Line :
City : TEMPE
State : AZ
Zip : 85281-9126
Country : US
Telephone Number : 602-885-9575
Fax Number : 480-718-7657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 07/01/2020

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