Provider Demographics
NPI:1023181765
Name:FRANKE, MICHAEL PATRICK (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PATRICK
Last Name:FRANKE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 E CAMP LOWELL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1282
Mailing Address - Country:US
Mailing Address - Phone:520-320-7712
Mailing Address - Fax:520-320-7638
Practice Address - Street 1:4510 E CAMP LOWELL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1282
Practice Address - Country:US
Practice Address - Phone:520-320-7712
Practice Address - Fax:520-320-7638
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0294100OtherBLUE CROSS BLUE SHIELD
AZ1Z4806OtherHEALTHNET ID NUMBER
AZ1Z4806OtherHEALTHNET ID NUMBER
AZ27851Medicare ID - Type UnspecifiedPROVIDER ID NUMBER