Provider Demographics
NPI:1497820518
Name:PAPPAS, MANO BORG (PT)
Entity Type:Individual
Prefix:
First Name:MANO
Middle Name:BORG
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7449 E OSBORN RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6448
Mailing Address - Country:US
Mailing Address - Phone:480-949-7699
Mailing Address - Fax:
Practice Address - Street 1:7449 E OSBORN RD
Practice Address - Street 2:SUITE 3
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6448
Practice Address - Country:US
Practice Address - Phone:480-949-7699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0370225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ18-07-0921OtherSTATE COMP FUND