Provider Demographics
NPI:1568789568
Name:HEATHER S. LEVENTHAL MPT, PLLC
Entity Type:Organization
Organization Name:HEATHER S. LEVENTHAL MPT, PLLC
Other - Org Name:CORE WELLNESS OF SCOTTSDALE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:SPLAINE
Authorized Official - Last Name:LEVENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:480-513-3839
Mailing Address - Street 1:9375 E BELL RD STE 107
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1541
Mailing Address - Country:US
Mailing Address - Phone:480-513-3839
Mailing Address - Fax:480-513-3117
Practice Address - Street 1:9375 E BELL RD STE 107
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1541
Practice Address - Country:US
Practice Address - Phone:480-513-3839
Practice Address - Fax:480-513-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8712225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty