Provider Demographics
NPI:1013425792
Name:ONE ACCORD PT SCOTTSDALE PLLC
Entity Type:Organization
Organization Name:ONE ACCORD PT SCOTTSDALE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:FLANNAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-617-5840
Mailing Address - Street 1:1377 E FLORENCE BLVD STE 151-L5
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5357
Mailing Address - Country:US
Mailing Address - Phone:602-821-8883
Mailing Address - Fax:
Practice Address - Street 1:5415 E HIGH ST STE 105
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-5461
Practice Address - Country:US
Practice Address - Phone:602-821-8883
Practice Address - Fax:602-821-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ225100000X, 225200000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty