Basic Information
| Provider Information | |||||||||
| NPI: | 1922281948 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RICH PHYSICAL THERAPY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7400 S POWER RD | ||||||||
| Address2: | BLDG 3 STE 112 | ||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852979281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806825460 | ||||||||
| FaxNumber: | 4806825465 | ||||||||
| Practice Location | |||||||||
| Address1: | 3271 N CIVIC CENTER PLZ | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852516990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802201793 | ||||||||
| FaxNumber: | 4806825465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2007 | ||||||||
| LastUpdateDate: | 12/12/2007 | ||||||||
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| AuthorizedOfficialLastName: | RICH | ||||||||
| AuthorizedOfficialFirstName: | DOUG | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4802201793 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 3080 | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.