Provider Demographics
NPI:1669531240
Name:HOSMER PHYSICAL THERAPY CORP.
Entity type:Organization
Organization Name:HOSMER PHYSICAL THERAPY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOSMER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-949-7963
Mailing Address - Street 1:7331 E OSBORN DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6435
Mailing Address - Country:US
Mailing Address - Phone:480-949-7963
Mailing Address - Fax:
Practice Address - Street 1:7331 E OSBORN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6435
Practice Address - Country:US
Practice Address - Phone:480-949-7963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0297860OtherBCBS
AZ689094OtherAHCCCS
AZS75343Medicare UPIN