Provider Demographics
NPI:1558983890
Name:DESERT WINDS PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:DESERT WINDS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:480-415-9700
Mailing Address - Street 1:37061 N STONEWARE DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-5290
Mailing Address - Country:US
Mailing Address - Phone:480-415-9700
Mailing Address - Fax:
Practice Address - Street 1:37061 N STONEWARE DR
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85140-5290
Practice Address - Country:US
Practice Address - Phone:480-415-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-09
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy