Provider Demographics
NPI:1558941724
Name:THIN AIR PHYSICAL THERAPY, PLLC.
Entity Type:Organization
Organization Name:THIN AIR PHYSICAL THERAPY, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:623-203-8157
Mailing Address - Street 1:399 S MALPAIS LN STE 103
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-6299
Mailing Address - Country:US
Mailing Address - Phone:928-235-5506
Mailing Address - Fax:928-220-8888
Practice Address - Street 1:399 S MALPAIS LN STE 103
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-6299
Practice Address - Country:US
Practice Address - Phone:623-203-8157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ098225Medicaid