Provider Demographics
NPI: | 1669157525 |
---|---|
Name: | THE PELVIC DOCS, LLC |
Entity type: | Organization |
Organization Name: | THE PELVIC DOCS, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PT/OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | SEAN |
Authorized Official - Middle Name: | O |
Authorized Official - Last Name: | FLANNAGAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DPT |
Authorized Official - Phone: | 602-821-8883 |
Mailing Address - Street 1: | 580 N CAMINO MERCADO STE 25 |
Mailing Address - Street 2: | |
Mailing Address - City: | CASA GRANDE |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85122-5757 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 520-840-0333 |
Mailing Address - Fax: | 888-381-6179 |
Practice Address - Street 1: | 2020 N CENTRAL AVE STE 550 |
Practice Address - Street 2: | |
Practice Address - City: | PHOENIX |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85004-4578 |
Practice Address - Country: | US |
Practice Address - Phone: | 855-331-7522 |
Practice Address - Fax: | 888-381-6170 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-06-19 |
Last Update Date: | 2023-06-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty |