Provider Demographics
NPI:1295084176
Name:RICE, SHAUN (PT)
Entity type:Individual
Prefix:
First Name:SHAUN
Middle Name:
Last Name:RICE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7430 E PINNACLE PEAK RD STE 138
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3630
Mailing Address - Country:US
Mailing Address - Phone:480-502-4324
Mailing Address - Fax:480-502-1397
Practice Address - Street 1:7430 E PINNACLE PEAK RD STE 138
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3630
Practice Address - Country:US
Practice Address - Phone:480-502-4324
Practice Address - Fax:480-502-1397
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ90824Medicare PIN