Basic Information
| Provider Information | |||||||||
| NPI: | 1588661888 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RICE | ||||||||
| FirstName: | DOUGLAS | ||||||||
| MiddleName: | BROWN | ||||||||
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| Credential: | BSPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2933 N 9TH AVE | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850134005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6023177592 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20045 N 19TH AVE | ||||||||
| Address2: | BLDG 8 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850274252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235949034 | ||||||||
| FaxNumber: | 6235949868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2005 | ||||||||
| LastUpdateDate: | 03/09/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 3140 | AZ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.