Provider Demographics
NPI:1922842483
Name:ORTHOPEDIC THERAPY AND WELLNESS
Entity type:Organization
Organization Name:ORTHOPEDIC THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-921-9000
Mailing Address - Street 1:2525 S RURAL RD STE 5S
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2444
Mailing Address - Country:US
Mailing Address - Phone:480-921-9000
Mailing Address - Fax:480-718-8160
Practice Address - Street 1:6245 N 24TH ST STE 105
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-2034
Practice Address - Country:US
Practice Address - Phone:602-997-7844
Practice Address - Fax:480-718-8160
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPEDIC THERAPY AND WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty