Provider Demographics
NPI:1073934600
Name:HARDING, JOSIE (ATC)
Entity Type:Individual
Prefix:
First Name:JOSIE
Middle Name:
Last Name:HARDING
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 N EL MIRAGE DR
Mailing Address - Street 2:APT 4712
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-3843
Mailing Address - Country:US
Mailing Address - Phone:307-256-0399
Mailing Address - Fax:
Practice Address - Street 1:6745 E SUPERSTITION SPRINGS BLVD
Practice Address - Street 2:APT 2056
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4312
Practice Address - Country:US
Practice Address - Phone:307-256-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-27
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer