Provider Demographics
NPI:1942255898
Name:VALLEY PHYSICAL THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:VALLEY PHYSICAL THERAPY SERVICES, LLC
Other - Org Name:INSTITUTE FOR PHYSICAL THERAPY, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:LOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-922-1376
Mailing Address - Street 1:9700 N 91ST ST
Mailing Address - Street 2:A-115
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5054
Mailing Address - Country:US
Mailing Address - Phone:480-922-1376
Mailing Address - Fax:480-922-8783
Practice Address - Street 1:9700 N 91ST ST
Practice Address - Street 2:A-115
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5054
Practice Address - Country:US
Practice Address - Phone:480-922-1376
Practice Address - Fax:480-922-8783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0461670OtherBLUE CROSS BLUE SHIELD
AZZ75602Medicare ID - Type Unspecified