Provider Demographics
NPI:1659578995
Name:ROBINETTE, JODI (PTA)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:ROBINETTE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13625 S 48TH ST
Mailing Address - Street 2:APT 2163
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-5000
Mailing Address - Country:US
Mailing Address - Phone:480-343-2789
Mailing Address - Fax:
Practice Address - Street 1:1221 W WARNER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1906
Practice Address - Country:US
Practice Address - Phone:480-735-0124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7727A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant