Provider Demographics
NPI:1073097002
Name:MCCONNELL, ZACHARY JAMES (DPT)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:JAMES
Last Name:MCCONNELL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 WIGWAM PKWY APT 2517
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8288
Mailing Address - Country:US
Mailing Address - Phone:269-312-1231
Mailing Address - Fax:
Practice Address - Street 1:1590 W SUNSET RD STE 110
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6633
Practice Address - Country:US
Practice Address - Phone:702-818-5000
Practice Address - Fax:702-818-5001
Is Sole Proprietor?:No
Enumeration Date:2018-09-15
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-30243225100000X
NV4341225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist