Provider Demographics
NPI:1932417508
Name:FOOTWORKS PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:FOOTWORKS PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:D'AMBROSIO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:480-518-0458
Mailing Address - Street 1:4530 N 32ND ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3357
Mailing Address - Country:US
Mailing Address - Phone:480-518-0458
Mailing Address - Fax:
Practice Address - Street 1:4530 N 32ND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3357
Practice Address - Country:US
Practice Address - Phone:480-518-0458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5703225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty