Provider Demographics
NPI:1871561605
Name:ANAYA PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:ANAYA PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:ANAYA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:520-294-9334
Mailing Address - Street 1:165 W AJO WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713
Mailing Address - Country:US
Mailing Address - Phone:520-294-9334
Mailing Address - Fax:520-294-2805
Practice Address - Street 1:165 W AJO WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713
Practice Address - Country:US
Practice Address - Phone:520-294-9334
Practice Address - Fax:520-294-2805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2414225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZRPT2414Medicare PIN