Provider Demographics
NPI:1376691741
Name:ANTHONY W HARDEN PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ANTHONY W HARDEN PHYSICAL THERAPY
Other - Org Name:PEAK PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:W
Authorized Official - Last Name:HARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-893-1321
Mailing Address - Street 1:15810 S 45TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048
Mailing Address - Country:US
Mailing Address - Phone:480-893-1321
Mailing Address - Fax:480-893-3148
Practice Address - Street 1:15810 S 45TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048
Practice Address - Country:US
Practice Address - Phone:480-893-1321
Practice Address - Fax:480-893-3148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0462920OtherBCBS
2Z0482OtherHEALTHNET
188735501OtherOWCP
188735500OtherOWCP
5403659OtherAETNA
AZZ64032Medicare ID - Type Unspecified
2Z0482OtherHEALTHNET