Provider Demographics
NPI:1952811929
Name:ARASTOO, MARYAM (PT)
Entity Type:Individual
Prefix:
First Name:MARYAM
Middle Name:
Last Name:ARASTOO
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 1:4630 S LAKESHORE DR APT 229
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7175
Mailing Address - Country:US
Mailing Address - Phone:919-917-6046
Mailing Address - Fax:
Practice Address - Street 1:5045 W BASELINE RD STE 120
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-7393
Practice Address - Country:US
Practice Address - Phone:602-605-8982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist