Provider Demographics
NPI:1124669692
Name:LIPSCHULTZ, NAOMI (PT)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:LIPSCHULTZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:GROSSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:16230 N 37TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3210
Mailing Address - Country:US
Mailing Address - Phone:602-451-2413
Mailing Address - Fax:
Practice Address - Street 1:7501 E THOMPSON PEAK PKWY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4525
Practice Address - Country:US
Practice Address - Phone:480-659-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30869225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist