Basic Information
| Provider Information | |||||||||
| NPI: | 1154363638 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CAREFREE PHYSICAL THERAPY, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5924 | ||||||||
| Address2: | |||||||||
| City: | CAREFREE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853775924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804889095 | ||||||||
| FaxNumber: | 4804882862 | ||||||||
| Practice Location | |||||||||
| Address1: | 7208 E CAVE CREEK RD | ||||||||
| Address2: | SUITE H | ||||||||
| City: | CAREFREE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853779600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804889095 | ||||||||
| FaxNumber: | 4804882862 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2006 | ||||||||
| LastUpdateDate: | 07/19/2007 | ||||||||
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| AuthorizedOfficialLastName: | KISH | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4804889095 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.