Provider Demographics
NPI:1376003368
Name:JT WEBBER PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:JT WEBBER PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBBER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:480-590-4412
Mailing Address - Street 1:6990 E SHEA BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5208
Mailing Address - Country:US
Mailing Address - Phone:480-590-4412
Mailing Address - Fax:
Practice Address - Street 1:6990 E SHEA BLVD STE 108
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5208
Practice Address - Country:US
Practice Address - Phone:480-590-4412
Practice Address - Fax:480-590-4413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy