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NPI Code Detail

MEDICARE: MRS. STEPHANIE RUTH PATTERSON PTA

MEDICARE: MRS. STEPHANIE RUTH PATTERSON PTA
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
1174400000XSpecialist7099AAZ

General Provider Information

NPI Number : 1841526597
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEPHANIE RUTH PATTERSON PTA
Provider Business Mailing Address
First Line : 5125 N 58TH AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85301-7453
Country : US
Telephone Number : 623-931-5800
Fax Number : 623-931-8776
Provider Business Practice Location Address
First Line : 5125 N 58TH AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85301-7453
Country : US
Telephone Number : 623-931-5800
Fax Number : 623-931-8776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2009
Last Update Date : 10/29/2009

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Directions to “ MRS. STEPHANIE RUTH PATTERSON PTA” Practice Location

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