Provider Demographics
NPI:1487838140
Name:ARIZONA PHYSICAL THERAPY, PC
Entity type:Organization
Organization Name:ARIZONA PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANDROFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT, SCD
Authorized Official - Phone:520-889-1622
Mailing Address - Street 1:1825 W. CALLE TRANQUILA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745
Mailing Address - Country:US
Mailing Address - Phone:520-889-1622
Mailing Address - Fax:520-889-1618
Practice Address - Street 1:2900 E BROADWAY BLVD
Practice Address - Street 2:SUITE 132
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-5343
Practice Address - Country:US
Practice Address - Phone:520-889-1622
Practice Address - Fax:520-889-1618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
AZ1899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty