Provider Demographics
NPI:1659345437
Name:WHEELER, PAUL CHRISTOPHER (PT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:CHRISTOPHER
Last Name:WHEELER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 S PAPERFLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-3536
Mailing Address - Country:US
Mailing Address - Phone:520-440-7860
Mailing Address - Fax:520-203-7659
Practice Address - Street 1:8701 S KOLB RD
Practice Address - Street 2:#7-202
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85756-9607
Practice Address - Country:US
Practice Address - Phone:520-440-7860
Practice Address - Fax:520-203-7659
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4250225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ109368Medicare PIN
AZZ62984Medicare PIN