Basic Information
| Provider Information | |||||||||
| NPI: | 1912955717 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSICAL THERAPY SOLUTIONS LLC | ||||||||
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| OtherOrganizationName: | PHYSICIANS PHYSICAL THERAPY SERVICE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 N 12TH ST | ||||||||
| Address2: | SUITE 506 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850062848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022304478 | ||||||||
| FaxNumber: | 6022309962 | ||||||||
| Practice Location | |||||||||
| Address1: | 18275 N 59TH AVE | ||||||||
| Address2: | BLDG K, SUITE 164 | ||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853081260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022304478 | ||||||||
| FaxNumber: | 6022309962 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 08/13/2012 | ||||||||
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| AuthorizedOfficialLastName: | GALLOWAY | ||||||||
| AuthorizedOfficialFirstName: | TAMARA | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6022304478 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.