Provider Demographics
NPI:1396404042
Name:MACHADO, MARCO A (PT)
Entity Type:Individual
Prefix:
First Name:MARCO
Middle Name:A
Last Name:MACHADO
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 1:8010 E MCDOWELL RD STE 113
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3868
Mailing Address - Country:US
Mailing Address - Phone:480-569-2442
Mailing Address - Fax:480-569-2643
Practice Address - Street 1:8010 E MCDOWELL RD STE 113
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3868
Practice Address - Country:US
Practice Address - Phone:480-569-2442
Practice Address - Fax:480-569-2643
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31882225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist