Provider Demographics
NPI:1801219639
Name:SPOONER AHWATUKEE HAND THERAPY, PC
Entity Type:Organization
Organization Name:SPOONER AHWATUKEE HAND THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPOONER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, FAFS
Authorized Official - Phone:602-527-0586
Mailing Address - Street 1:9097 E DESERT COVE AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6279
Mailing Address - Country:US
Mailing Address - Phone:480-551-4961
Mailing Address - Fax:480-860-0356
Practice Address - Street 1:16515 S 40TH ST
Practice Address - Street 2:STE 119B
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0558
Practice Address - Country:US
Practice Address - Phone:480-889-2223
Practice Address - Fax:480-889-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty