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NPI Code Detail

MEDICARE: MARTHA CARR P.T.

MEDICARE: MARTHA CARR 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
1225100000XPhysical Therapist6039AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861579476
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA CARR P.T.
Provider Business Mailing Address
First Line : 16445 N PALO VERDE LN
Second Line :
City : FOUNTAIN HILLS
State : AZ
Zip : 85268-1325
Country : US
Telephone Number : 480-816-1928
Fax Number : 480-836-0257
Provider Business Practice Location Address
First Line : 10251 N 35TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-1305
Country : US
Telephone Number : 602-995-7366
Fax Number : 602-995-0867
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/09/2007

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