Provider Demographics
NPI:1871324921
Name:LOTTES, ZACHARY ROBERT (ATC)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:ROBERT
Last Name:LOTTES
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N SCOTTSDALE RD APT 3017
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288-3905
Mailing Address - Country:US
Mailing Address - Phone:608-807-6566
Mailing Address - Fax:
Practice Address - Street 1:650 S ATHLETES PL
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85288-8519
Practice Address - Country:US
Practice Address - Phone:480-965-4854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZATR-1001172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer