Provider Demographics
NPI:1669482519
Name:VOSEKALNS, SHARON L (PT)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:L
Last Name:VOSEKALNS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:SHARON
Other - Middle Name:L
Other - Last Name:WOLFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:17100 N 67THAVE
Mailing Address - Street 2:BLDG 1
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3612
Mailing Address - Country:US
Mailing Address - Phone:623-979-2747
Mailing Address - Fax:623-979-3122
Practice Address - Street 1:17100 N 67TH AVE
Practice Address - Street 2:BLDG 1
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3612
Practice Address - Country:US
Practice Address - Phone:623-979-2747
Practice Address - Fax:623-979-3122
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ83182251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30393896Medicaid
NH30393896Medicaid