Provider Demographics
NPI:1104521616
Name:ARIZONA MOBILE THERAPY LLC
Entity type:Organization
Organization Name:ARIZONA MOBILE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-698-6049
Mailing Address - Street 1:15239 W ALEXANDRIA WAY
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-8104
Mailing Address - Country:US
Mailing Address - Phone:480-698-6049
Mailing Address - Fax:480-371-2743
Practice Address - Street 1:15239 W ALEXANDRIA WAY
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-8104
Practice Address - Country:US
Practice Address - Phone:480-698-6049
Practice Address - Fax:480-371-2743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty