Provider Demographics
NPI:1134172380
Name:ZICCARDI, VERONICA M (PT)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:M
Last Name:ZICCARDI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:VERONICA
Other - Middle Name:M
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:22431 N BISHOP DR
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85239-9373
Mailing Address - Country:US
Mailing Address - Phone:520-568-9001
Mailing Address - Fax:
Practice Address - Street 1:DESERT VIEW PHYSICAL THERAPY
Practice Address - Street 2:6641 E BAYWOOD AVE. SUITE A-4
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-396-9020
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6051174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist