MEDICARE: ARIZONA ORTHOPEDIC PHYSICAL THERAPY, PLLC

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	261QP2000X	Physical Therapy Clinic/Center	NOT REQUIRED	AZ

General Provider Information

NPI Number	:	1851490627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA ORTHOPEDIC PHYSICAL THERAPY, PLLC

Provider Business Mailing Address
First Line	:	14557 W INDIAN SCHOOL RD
Second Line	:	# 500
City	:	GOODYEAR
State	:	AZ
Zip	:	85395-9243
Country	:	US
Telephone Number	:	623-242-6908
Fax Number	:	623-242-6909

Provider Business Practice Location Address
First Line	:	14557 W INDIAN SCHOOL RD
Second Line	:	# 500
City	:	GOODYEAR
State	:	AZ
Zip	:	85395-9243
Country	:	US
Telephone Number	:	623-242-6908
Fax Number	:	623-242-6909

Authorized Official
Title or Position	:	OWNER/MEMBER/PHYSICAL THERAPIST
Name	:	RYANN P ROBERTS
Credential	:	DPT
Telephone Number	:	623-242-6908

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	02/06/2024

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