Provider Demographics
NPI:1326007337
Name:CHIESI, MICHAEL (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CHIESI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 N ORACLE RD
Mailing Address - Street 2:#101
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-3829
Mailing Address - Country:US
Mailing Address - Phone:520-408-9547
Mailing Address - Fax:520-293-6638
Practice Address - Street 1:1925 W ORANGE GROVE RD
Practice Address - Street 2:# 204
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1143
Practice Address - Country:US
Practice Address - Phone:520-297-1550
Practice Address - Fax:520-297-1556
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2010-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ86-0977426OtherEIN