Provider Demographics
NPI:1275042665
Name:EHLER, VIRGINIA M (PT)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:M
Last Name:EHLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:M
Other - Last Name:ALVINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 1282
Mailing Address - Street 2:
Mailing Address - City:CORTARO
Mailing Address - State:AZ
Mailing Address - Zip Code:85652-1282
Mailing Address - Country:US
Mailing Address - Phone:520-440-3141
Mailing Address - Fax:
Practice Address - Street 1:11290 W GRIER RD
Practice Address - Street 2:
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85653-9609
Practice Address - Country:US
Practice Address - Phone:520-682-4782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist