Provider Demographics
NPI:1184742314
Name:EARLY, BETHANY L (PT, DPT)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:L
Last Name:EARLY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 E MORELOS ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2078
Mailing Address - Country:US
Mailing Address - Phone:520-921-0585
Mailing Address - Fax:
Practice Address - Street 1:793 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE D4
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-3681
Practice Address - Country:US
Practice Address - Phone:480-626-4142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ73302251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics