Provider Demographics
NPI:1326914110
Name:INNERVATION PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:INNERVATION PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ESQUEDA
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:928-446-4463
Mailing Address - Street 1:264 W 32ND ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8152
Mailing Address - Country:US
Mailing Address - Phone:928-920-8735
Mailing Address - Fax:
Practice Address - Street 1:264 W 32ND ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8152
Practice Address - Country:US
Practice Address - Phone:928-920-8735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty