MEDICARE: MICHAEL RYAN KALER P.T.

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	8306	AZ

General Provider Information

NPI Number	:	1639166606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL RYAN KALER P.T.

Provider Business Mailing Address
First Line	:	34597 N 60TH ST
Second Line	:	SUITE 100
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85266-5240
Country	:	US
Telephone Number	:	480-588-7979
Fax Number	:	480-588-5448

Provider Business Practice Location Address
First Line	:	34597 N 60TH ST
Second Line	:	SUITE 100
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85266-5240
Country	:	US
Telephone Number	:	480-588-7979
Fax Number	:	480-588-5448

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	06/12/2015

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