Provider Demographics
NPI:1174867832
Name:KOESTNER, MAY ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:ELIZABETH
Last Name:KOESTNER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 W BECK LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-4447
Mailing Address - Country:US
Mailing Address - Phone:602-863-4444
Mailing Address - Fax:
Practice Address - Street 1:717 W BECK LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-4447
Practice Address - Country:US
Practice Address - Phone:602-863-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9890PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist