Provider Demographics
NPI:1104486455
Name:DESERT HILLS PHYSICAL THERAPY AND WELLNESS LLC
Entity type:Organization
Organization Name:DESERT HILLS PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:520-595-0506
Mailing Address - Street 1:20998 E DESERT HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6937
Mailing Address - Country:US
Mailing Address - Phone:520-595-0506
Mailing Address - Fax:
Practice Address - Street 1:20998 E DESERT HILLS BLVD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6937
Practice Address - Country:US
Practice Address - Phone:520-595-0506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty