Provider Demographics
NPI:1174249072
Name:WEST AZ PT LLC
Entity type:Organization
Organization Name:WEST AZ PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRUTI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:602-430-1993
Mailing Address - Street 1:3602 E GREENWAY RD STE 106
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4648
Mailing Address - Country:US
Mailing Address - Phone:602-715-2237
Mailing Address - Fax:602-715-2238
Practice Address - Street 1:3602 E GREENWAY RD STE 106
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4648
Practice Address - Country:US
Practice Address - Phone:602-715-2237
Practice Address - Fax:602-715-2238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty