Provider Demographics
NPI:1578826731
Name:MYERS, RITA L (PT)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:L
Last Name:MYERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 E BASELINE ROAD
Mailing Address - Street 2:STE C-5
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1506
Mailing Address - Country:US
Mailing Address - Phone:480-833-1005
Mailing Address - Fax:480-833-1312
Practice Address - Street 1:1844 E BASELINE ROAD
Practice Address - Street 2:STE C-5
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1506
Practice Address - Country:US
Practice Address - Phone:480-833-1005
Practice Address - Fax:480-833-1312
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52882251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic