Provider Demographics
NPI:1003299678
Name:VANCE, HILLARY KRISTI (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:HILLARY
Middle Name:KRISTI
Last Name:VANCE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6320A W UNION HILLS DR
Mailing Address - Street 2:SUITE 265
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7177
Mailing Address - Country:US
Mailing Address - Phone:623-374-2424
Mailing Address - Fax:623-374-2619
Practice Address - Street 1:20045 N 19TH AVE
Practice Address - Street 2:BUILDING 8
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4252
Practice Address - Country:US
Practice Address - Phone:623-594-9034
Practice Address - Fax:623-594-9868
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11597225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist