Provider Demographics
NPI:1639203995
Name:MWR PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:MWR PHYSICAL THERAPY INC
Other - Org Name:RESOTRE PHYSICAL THERAPY AND SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-980-6288
Mailing Address - Street 1:7400 S POWER RD BLDG 3 STE 112
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-9282
Mailing Address - Country:US
Mailing Address - Phone:480-682-5460
Mailing Address - Fax:480-682-5465
Practice Address - Street 1:7400 S POWER RD BLDG 3 STE 112
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-9282
Practice Address - Country:US
Practice Address - Phone:480-682-5460
Practice Address - Fax:480-682-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5220225100000X
AZ7101A225200000X
AZ00802255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty