Provider Demographics
NPI:1619343761
Name:LEIKER, CLAIRE ELIZABETH (DPT)
Entity Type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:ELIZABETH
Last Name:LEIKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:CLAIRE
Other - Middle Name:ELIZABETH
Other - Last Name:ROTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:10133 N 92ND ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4556
Mailing Address - Country:US
Mailing Address - Phone:480-584-3334
Mailing Address - Fax:480-272-9369
Practice Address - Street 1:10133 N 92ND ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4556
Practice Address - Country:US
Practice Address - Phone:480-584-3334
Practice Address - Fax:480-272-9369
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-05198225100000X
AZ11806225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ180289Medicare PIN