Provider Demographics
NPI:1891818159
Name:JUDITH STRATTON, P.T., L.L.C.
Entity Type:Organization
Organization Name:JUDITH STRATTON, P.T., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:STRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:928-286-1673
Mailing Address - Street 1:492 W PHILOMENA DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-1367
Mailing Address - Country:US
Mailing Address - Phone:928-286-1673
Mailing Address - Fax:
Practice Address - Street 1:492 W PHILOMENA DR
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-1367
Practice Address - Country:US
Practice Address - Phone:928-286-1673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty