MEDICARE: EMPOWER PHOENIX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1770120305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWER PHOENIX LLC

Provider Business Mailing Address
First Line	:	5830 W THUNDERBIRD RD STE B8
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4655
Country	:	US
Telephone Number	:	928-683-1392
Fax Number	:	480-781-4464

Provider Business Practice Location Address
First Line	:	14627 N 60TH AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-3805
Country	:	US
Telephone Number	:	928-233-6263
Fax Number	:	480-781-4464

Authorized Official
Title or Position	:	OWNER
Name	:	MILES CHRISTENSON
Credential	:	MS SLP
Telephone Number	:	928-683-1392

Provider Enumeration Date	:	12/02/2019
Last Update Date	:	05/26/2026

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Directions to “EMPOWER PHOENIX LLC ” Practice Location

Language	Start Address	Practice Location

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