Provider Demographics
NPI:1427182351
Name:BALDERSON, JANE R (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:R
Last Name:BALDERSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:K
Other - Last Name:RATTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:10451 W PALMERAS DR
Mailing Address - Street 2:SUITE 209 EAST
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85373-2011
Mailing Address - Country:US
Mailing Address - Phone:633-933-1896
Mailing Address - Fax:
Practice Address - Street 1:13629 W CAMINO DEL SOL
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375
Practice Address - Country:US
Practice Address - Phone:866-476-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ114262Medicare PIN
AZP00372824Medicare UPIN
AZP00372824Medicare PIN