Provider Demographics
NPI:1922200963
Name:NORTHERN ARIZONA PHYSICAL THERAPY
Entity Type:Organization
Organization Name:NORTHERN ARIZONA PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYICAL THERAPIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAUER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:928-282-3950
Mailing Address - Street 1:PO BOX 4203
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86340-4203
Mailing Address - Country:US
Mailing Address - Phone:928-282-3950
Mailing Address - Fax:928-282-6990
Practice Address - Street 1:2155 W HIGHWAY 89A
Practice Address - Street 2:SUITE 103
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5468
Practice Address - Country:US
Practice Address - Phone:928-282-3950
Practice Address - Fax:928-282-6990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0843261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ64132Medicare PIN
AZR10488Medicare UPIN