Provider Demographics
NPI:1508485772
Name:COYLE, FIONA MICHELLE (PT)
Entity Type:Individual
Prefix:MISS
First Name:FIONA
Middle Name:MICHELLE
Last Name:COYLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:FIONA
Other - Middle Name:MICHELLE
Other - Last Name:COLLIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:322 E VIA PUENTE LINDO
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8884
Mailing Address - Country:US
Mailing Address - Phone:520-333-8224
Mailing Address - Fax:
Practice Address - Street 1:155 W DUVAL RD
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-4207
Practice Address - Country:US
Practice Address - Phone:520-648-3132
Practice Address - Fax:520-648-1861
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZIP-20-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1215995493OtherCLINIC NPI