Provider Demographics
NPI:1801062484
Name:VASZAR, SHELLEY (PT)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:VASZAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15425 N GREENWAY HAYDEN LOOP STE A250
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1241
Mailing Address - Country:US
Mailing Address - Phone:480-664-9988
Mailing Address - Fax:
Practice Address - Street 1:15425 N GREENWAY HAYDEN LOOP STE A250
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1241
Practice Address - Country:US
Practice Address - Phone:480-664-9988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist