Provider Demographics
NPI:1376278317
Name:SPOONER PHYSICAL THERAPY & HAND REHAB, PC
Entity Type:Organization
Organization Name:SPOONER PHYSICAL THERAPY & HAND REHAB, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPOONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-527-0586
Mailing Address - Street 1:14287 N 87TH ST STE 220
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3698
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1199 S BELT LINE RD STE 140
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-7610
Practice Address - Country:US
Practice Address - Phone:972-745-9060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPOONER PHYSICAL THERAPY & HAND REHAB, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-22
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy