Provider Demographics
NPI:1548416134
Name:COUSENS, TIMOTHY P JR (PT,DPT,MS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:P
Last Name:COUSENS
Suffix:JR
Gender:M
Credentials:PT,DPT,MS
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Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:NAVAJO HEALTH FOUNDATION/SAGE MEMORIAL HOSPITAL/PT DEPT
Mailing Address - City:GANADO
Mailing Address - State:AZ
Mailing Address - Zip Code:86505-0457
Mailing Address - Country:US
Mailing Address - Phone:928-755-4566
Mailing Address - Fax:928-755-4567
Practice Address - Street 1:HIGHWAY 264 AND 191 SOUTH
Practice Address - Street 2:NAVAJO HEALTH FOUNDATION/SAGE MEMORIAL HOSPITAL/PT DEPT
Practice Address - City:GANADO
Practice Address - State:AZ
Practice Address - Zip Code:86505
Practice Address - Country:US
Practice Address - Phone:928-755-4566
Practice Address - Fax:928-755-4567
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
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Provider Licenses
StateLicense IDTaxonomies
AZ5211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist