Provider Demographics
NPI:1447547815
Name:FOUCRIER, JEFFREY PETER (DPT)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:PETER
Last Name:FOUCRIER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9097 E DESERT COVE AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6710
Mailing Address - Country:US
Mailing Address - Phone:480-860-4298
Mailing Address - Fax:480-860-0165
Practice Address - Street 1:9097 E DESERT COVE AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6710
Practice Address - Country:US
Practice Address - Phone:480-860-4298
Practice Address - Fax:480-860-0165
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10032225100000X
WY1377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist