Provider Demographics
NPI:1871769976
Name:SONORAN PHYSICAL THERAPY
Entity type:Organization
Organization Name:SONORAN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:602-443-4196
Mailing Address - Street 1:1432 S DOBSON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4768
Mailing Address - Country:US
Mailing Address - Phone:480-962-0071
Mailing Address - Fax:480-962-0590
Practice Address - Street 1:1255 W RIO SALADO PKWY STE 107
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2892
Practice Address - Country:US
Practice Address - Phone:480-962-0071
Practice Address - Fax:480-962-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy