Provider Demographics
NPI:1922468024
Name:SCHIPPERS, SASHA (DPT)
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:SCHIPPERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41818 N VENTURE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3189
Mailing Address - Country:US
Mailing Address - Phone:623-742-7338
Mailing Address - Fax:
Practice Address - Street 1:41818 N VENTURE DR STE 120
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-3189
Practice Address - Country:US
Practice Address - Phone:623-742-7338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist