Provider Demographics
NPI:1306963038
Name:ARIZONA ADVANCED THERAPY
Entity type:Organization
Organization Name:ARIZONA ADVANCED THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTRL
Authorized Official - Phone:480-963-5800
Mailing Address - Street 1:815 E WARNER RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-0994
Mailing Address - Country:US
Mailing Address - Phone:480-963-5800
Mailing Address - Fax:480-963-5805
Practice Address - Street 1:815 E WARNER RD
Practice Address - Street 2:SUITE 106
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-0994
Practice Address - Country:US
Practice Address - Phone:480-963-5800
Practice Address - Fax:480-963-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty