Provider Demographics
NPI:1194046052
Name:ARCHODAKIS, FOTINI (PT, DPT, GCS)
Entity Type:Individual
Prefix:
First Name:FOTINI
Middle Name:
Last Name:ARCHODAKIS
Suffix:
Gender:F
Credentials:PT, DPT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4202 E CACTUS RD APT 3105
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-0609
Mailing Address - Country:US
Mailing Address - Phone:520-260-5258
Mailing Address - Fax:
Practice Address - Street 1:4202 E CACTUS RD APT 3105
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-0609
Practice Address - Country:US
Practice Address - Phone:520-260-5258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-009169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist