Provider Demographics
NPI:1811264179
Name:JARECKI, BRITNI (DPT)
Entity type:Individual
Prefix:
First Name:BRITNI
Middle Name:
Last Name:JARECKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:959 LAS TABLAS RD
Mailing Address - Street 2:STE A4
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-9703
Mailing Address - Country:US
Mailing Address - Phone:480-688-5859
Mailing Address - Fax:480-452-1390
Practice Address - Street 1:3322 S MILL AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-4933
Practice Address - Country:US
Practice Address - Phone:480-838-4478
Practice Address - Fax:480-838-7839
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9602225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist