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NPI Code Detail

MEDICARE: TANNER CHITWOOD DPT

MEDICARE: TANNER CHITWOOD DPT
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 Therapist30019AZ

General Provider Information

NPI Number : 1972097178
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANNER CHITWOOD DPT
Provider Business Mailing Address
First Line : 14287 N 87TH ST STE 220
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85260-3698
Country : US
Telephone Number : 602-329-8250
Fax Number : 480-565-1898
Provider Business Practice Location Address
First Line : 5040 N 15TH AVE STE 401
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-3332
Country : US
Telephone Number : 602-285-0949
Fax Number : 602-285-0052
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2018
Last Update Date : 02/23/2022

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Directions to “ TANNER CHITWOOD DPT” Practice Location

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