Provider Demographics
NPI:1417712720
Name:RECOVIA PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:RECOVIA PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-712-4600
Mailing Address - Street 1:PO BOX 20216
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85036-0216
Mailing Address - Country:US
Mailing Address - Phone:480-712-4600
Mailing Address - Fax:602-428-7045
Practice Address - Street 1:9250 W THOMAS RD STE 250
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3362
Practice Address - Country:US
Practice Address - Phone:480-712-4600
Practice Address - Fax:602-428-7045
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECOVIA PHYSICAL THERAPY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty