Provider Demographics
NPI:1922281948
Name:RICH PHYSICAL THERAPY
Entity Type:Organization
Organization Name:RICH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-220-1793
Mailing Address - Street 1:7400 S POWER RD
Mailing Address - Street 2:BLDG 3 STE 112
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-9281
Mailing Address - Country:US
Mailing Address - Phone:480-682-5460
Mailing Address - Fax:480-682-5465
Practice Address - Street 1:3271 N CIVIC CENTER PLZ
Practice Address - Street 2:SUITE 3
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6990
Practice Address - Country:US
Practice Address - Phone:480-220-1793
Practice Address - Fax:480-682-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3080225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty