Provider Demographics
NPI:1194274159
Name:HARING, ANNETTE (PT, MPT)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:HARING
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:
Other - Last Name:GRIGSBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15410 S MOUNTAIN PKWY
Mailing Address - Street 2:SUITE 112
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-6691
Mailing Address - Country:US
Mailing Address - Phone:480-706-1161
Mailing Address - Fax:480-706-7997
Practice Address - Street 1:8555 N SILVERBELL RD
Practice Address - Street 2:SUITE 106
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-7005
Practice Address - Country:US
Practice Address - Phone:520-744-6445
Practice Address - Fax:520-742-5252
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12509225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist