Provider Demographics
NPI:1689629131
Name:KESSLER, CAROL (PT)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:KESSLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10475 E LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-2942
Mailing Address - Country:US
Mailing Address - Phone:480-380-2810
Mailing Address - Fax:480-380-2861
Practice Address - Street 1:7430 E PINNACLE PEAK RD
Practice Address - Street 2:SUITE 138
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3630
Practice Address - Country:US
Practice Address - Phone:480-502-4324
Practice Address - Fax:480-502-1397
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11433225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0298870OtherBCBS NUMBER
AZ71962Medicare ID - Type UnspecifiedMEDICARE NUMBER
AZ757700Medicaid