Provider Demographics
NPI:1710139852
Name:CROSSWINDS PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:CROSSWINDS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:METZLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:928-301-6230
Mailing Address - Street 1:312 W PHEASANT RUN CIR
Mailing Address - Street 2:
Mailing Address - City:CAMP VERDE
Mailing Address - State:AZ
Mailing Address - Zip Code:86322-6923
Mailing Address - Country:US
Mailing Address - Phone:928-301-6230
Mailing Address - Fax:928-567-8977
Practice Address - Street 1:312 W PHEASANT RUN CIR
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-6923
Practice Address - Country:US
Practice Address - Phone:928-301-6230
Practice Address - Fax:928-567-8977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6792225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty