Provider Demographics
NPI:1407436280
Name:TOWNSEND, ERIKA JADE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:JADE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 N COUNTRY CLUB DR APT 2058
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-1789
Mailing Address - Country:US
Mailing Address - Phone:626-643-1048
Mailing Address - Fax:
Practice Address - Street 1:861 N HIGLEY RD STE B-115
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-9602
Practice Address - Country:US
Practice Address - Phone:480-699-8473
Practice Address - Fax:480-219-8237
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist