Provider Demographics
NPI:1851664742
Name:PELLMAN, SHARON (PT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:PELLMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:ARSENAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:300 W CLARENDON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3422
Mailing Address - Country:US
Mailing Address - Phone:602-776-7676
Mailing Address - Fax:602-705-0567
Practice Address - Street 1:12550 W CAMPINA DR
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-5171
Practice Address - Country:US
Practice Address - Phone:602-576-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6135225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist