Provider Demographics
NPI:1669953923
Name:VILLA, RAMON III (PTA)
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:VILLA
Suffix:III
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:RAY
Other - Middle Name:
Other - Last Name:VILLA
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:1336 W LAWRENCE LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4439
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7800 E PIERCE ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-4606
Practice Address - Country:US
Practice Address - Phone:480-640-1135
Practice Address - Fax:480-597-1734
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12098A2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic