Provider Demographics
NPI:1457784886
Name:WESTERGARD, WILLIAM (PT, DPT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:WESTERGARD
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8987 E TANQUE VERDE RD
Mailing Address - Street 2:#309-275
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-9610
Mailing Address - Country:US
Mailing Address - Phone:480-433-5179
Mailing Address - Fax:480-786-5118
Practice Address - Street 1:5590 W CHANDLER BLVD
Practice Address - Street 2:#4
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3697
Practice Address - Country:US
Practice Address - Phone:480-786-4969
Practice Address - Fax:480-786-5118
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist