Provider Demographics
NPI:1528204195
Name:BLUE SKY PHYSICAL THERAPY & WELLNESS, LLC
Entity Type:Organization
Organization Name:BLUE SKY PHYSICAL THERAPY & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SOCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-513-8727
Mailing Address - Street 1:11785 E MARIPOSA GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5661
Mailing Address - Country:US
Mailing Address - Phone:480-513-8727
Mailing Address - Fax:480-513-3359
Practice Address - Street 1:11785 E MARIPOSA GRANDE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5661
Practice Address - Country:US
Practice Address - Phone:480-513-8727
Practice Address - Fax:480-513-3359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-01
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7957261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy