Provider Demographics
NPI:1144593609
Name:DENNIS R. ST JAMES PHYSICAL THERAPY LTD
Entity Type:Organization
Organization Name:DENNIS R. ST JAMES PHYSICAL THERAPY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:ST JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:602-266-9922
Mailing Address - Street 1:532 E MARYLAND AVENUE
Mailing Address - Street 2:STE C
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018
Mailing Address - Country:US
Mailing Address - Phone:602-266-9922
Mailing Address - Fax:602-266-6533
Practice Address - Street 1:532 EAST MARYLAND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012
Practice Address - Country:US
Practice Address - Phone:602-266-9922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENNIS R. ST JAMES PHYSICAL THERAPY, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1886494002251X0800X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZRPT785Medicare PIN