Provider Demographics
NPI:1023317112
Name:STAT,LLC
Entity type:Organization
Organization Name:STAT,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNICH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-722-0300
Mailing Address - Street 1:825 E WARNER RD
Mailing Address - Street 2:SUITE C100
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-0994
Mailing Address - Country:US
Mailing Address - Phone:480-722-0300
Mailing Address - Fax:480-722-0302
Practice Address - Street 1:825 E WARNER RD
Practice Address - Street 2:SUITE C100
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-0994
Practice Address - Country:US
Practice Address - Phone:480-722-0300
Practice Address - Fax:480-722-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5059261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy