Provider Demographics
NPI:1780460295
Name:AT HOME PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:AT HOME PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATY
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:602-750-7280
Mailing Address - Street 1:1255 N ARIZONA AVE UNIT 1217
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-0710
Mailing Address - Country:US
Mailing Address - Phone:602-750-7280
Mailing Address - Fax:
Practice Address - Street 1:1255 N ARIZONA AVE UNIT 1217
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-0710
Practice Address - Country:US
Practice Address - Phone:602-750-7280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty