Provider Demographics
NPI:1477165389
Name:HUNTER, NICHOLAS (PT, DPT)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:HUNTER
Suffix:
Gender:M
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 1:4850 E BASELINE RD STE 114
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4626
Mailing Address - Country:US
Mailing Address - Phone:480-396-2781
Mailing Address - Fax:480-854-3094
Practice Address - Street 1:5545 E BROADWAY BLVD STE 113
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3843
Practice Address - Country:US
Practice Address - Phone:520-372-2714
Practice Address - Fax:520-844-9950
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist