Basic Information
| Provider Information | |||||||||
| NPI: | 1003299678 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VANCE | ||||||||
| FirstName: | HILLARY | ||||||||
| MiddleName: | KRISTI | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6320A W UNION HILLS DR | ||||||||
| Address2: | SUITE 265 | ||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853087177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6233742424 | ||||||||
| FaxNumber: | 6233742619 | ||||||||
| Practice Location | |||||||||
| Address1: | 20045 N 19TH AVE | ||||||||
| Address2: | BUILDING 8 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850274252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235949034 | ||||||||
| FaxNumber: | 6235949868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2015 | ||||||||
| LastUpdateDate: | 07/01/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 11597 | AZ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.