Provider Demographics
NPI:1093042210
Name:MAJOR-KATZ, MICHELLE (PT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MAJOR-KATZ
Suffix:
Gender:F
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:PO BOX 17617
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85731-7617
Mailing Address - Country:US
Mailing Address - Phone:520-468-2214
Mailing Address - Fax:520-468-2214
Practice Address - Street 1:48 N TUCSON BLVD
Practice Address - Street 2:#100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-4757
Practice Address - Country:US
Practice Address - Phone:520-468-2214
Practice Address - Fax:520-468-2214
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2035225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ20-5386008OtherTIN