Provider Demographics
NPI:1134467970
Name:VERVE PHYSICAL THERAPY GROUP LLC
Entity Type:Organization
Organization Name:VERVE PHYSICAL THERAPY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:WARKENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:480-969-4040
Mailing Address - Street 1:4824 E BASELINE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4676
Mailing Address - Country:US
Mailing Address - Phone:480-969-4040
Mailing Address - Fax:480-830-9202
Practice Address - Street 1:4824 E BASELINE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4676
Practice Address - Country:US
Practice Address - Phone:480-969-4040
Practice Address - Fax:480-830-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-30
Last Update Date:2013-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty