Provider Demographics
NPI:1821424961
Name:NOONAN PHYSICAL THERAPY & ASSOCIATES RITA RANCH, LLC
Entity Type:Organization
Organization Name:NOONAN PHYSICAL THERAPY & ASSOCIATES RITA RANCH, LLC
Other - Org Name:NOONAN PHYSICAL THERAPY & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:NOONAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:520-885-4636
Mailing Address - Street 1:7545 S HOUGHTON RD
Mailing Address - Street 2:STE. 123
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-9377
Mailing Address - Country:US
Mailing Address - Phone:520-574-0200
Mailing Address - Fax:520-574-1800
Practice Address - Street 1:7545 S HOUGHTON RD
Practice Address - Street 2:STE. 123
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-9377
Practice Address - Country:US
Practice Address - Phone:520-574-0200
Practice Address - Fax:520-574-1800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-20
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ888164Medicaid
AZZ162667Medicare PIN
AZ7376100001Medicare NSC