Provider Demographics
NPI:1497881957
Name:NORTH SCOTTSDALE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:NORTH SCOTTSDALE PHYSICAL THERAPY, LLC
Other - Org Name:DESERT INSTITUTE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-355-9400
Mailing Address - Street 1:7550 E GREENWAY RD
Mailing Address - Street 2:#115
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1896
Mailing Address - Country:US
Mailing Address - Phone:480-998-4848
Mailing Address - Fax:480-998-2207
Practice Address - Street 1:7550 E GREENWAY RD
Practice Address - Street 2:#115
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1896
Practice Address - Country:US
Practice Address - Phone:480-998-4848
Practice Address - Fax:480-998-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0292950OtherBLUECROSS