Provider Demographics
NPI:1306081310
Name:WORK PHYSICAL THERAPY PLC
Entity type:Organization
Organization Name:WORK PHYSICAL THERAPY PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WIDD
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:480-632-6667
Mailing Address - Street 1:323 S GILBERT RD STE 115
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1608
Mailing Address - Country:US
Mailing Address - Phone:480-632-6667
Mailing Address - Fax:480-632-6668
Practice Address - Street 1:323 S GILBERT RD STE 115
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-1608
Practice Address - Country:US
Practice Address - Phone:480-632-6667
Practice Address - Fax:480-632-6668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy