Provider Demographics
NPI:1689740680
Name:VERTEX PHYSICAL THERAPY CORP
Entity Type:Organization
Organization Name:VERTEX PHYSICAL THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:THODE
Authorized Official - Suffix:
Authorized Official - Credentials:PT,MPT
Authorized Official - Phone:480-661-1124
Mailing Address - Street 1:9364 E RAINTREE DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2200
Mailing Address - Country:US
Mailing Address - Phone:480-661-1124
Mailing Address - Fax:480-661-1125
Practice Address - Street 1:9364 E RAINTREE DR
Practice Address - Street 2:SUITE 109
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2200
Practice Address - Country:US
Practice Address - Phone:480-661-1124
Practice Address - Fax:480-661-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ3847225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ100386OtherPIN
AZ2Z1802OtherHEALTH NET
AZ0463050OtherBCBS OF AZ
AZZ100076Medicare ID - Type Unspecified
AZ100386OtherPIN