Provider Demographics
NPI:1952136087
Name:TINY TO MIGHTY PEDIATRIC THERAPY LLC
Entity type:Organization
Organization Name:TINY TO MIGHTY PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MAURE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:480-330-0456
Mailing Address - Street 1:15825 S 46TH ST STE 128
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-0445
Mailing Address - Country:US
Mailing Address - Phone:480-330-0456
Mailing Address - Fax:
Practice Address - Street 1:15825 S 46TH ST STE 128
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0445
Practice Address - Country:US
Practice Address - Phone:480-330-0456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-06
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy