Provider Demographics
NPI:1295874337
Name:MOBILE PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:MOBILE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF MPT, INC.
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:FEARING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:602-369-7423
Mailing Address - Street 1:7119 E SHEA BLVD
Mailing Address - Street 2:#586
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6107
Mailing Address - Country:US
Mailing Address - Phone:602-369-7423
Mailing Address - Fax:
Practice Address - Street 1:7119 E SHEA BLVD
Practice Address - Street 2:#586
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6107
Practice Address - Country:US
Practice Address - Phone:602-369-7423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3165225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty