Provider Demographics
NPI:1881229599
Name:GAME CHANGER PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:GAME CHANGER PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:480-702-1634
Mailing Address - Street 1:4444 W CATHY CIR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3533
Mailing Address - Country:US
Mailing Address - Phone:480-702-1634
Mailing Address - Fax:480-680-8385
Practice Address - Street 1:4444 W CATHY CIR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3533
Practice Address - Country:US
Practice Address - Phone:480-702-1634
Practice Address - Fax:480-680-8385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy