Provider Demographics
NPI:1871566109
Name:PEERY, STEVEN M (PT, MPT)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:M
Last Name:PEERY
Suffix:
Gender:M
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 N LITCHFIELD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-7804
Mailing Address - Country:US
Mailing Address - Phone:623-935-0626
Mailing Address - Fax:623-935-5551
Practice Address - Street 1:10815 W MCDOWELL RD
Practice Address - Street 2:SUITE 203
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-5007
Practice Address - Country:US
Practice Address - Phone:623-907-4400
Practice Address - Fax:623-907-4610
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ6896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ146633Medicaid
AZZ107024Medicare UPIN