Provider Demographics
NPI:1316946379
Name:ARENSON WASSERBECK LLC
Entity type:Organization
Organization Name:ARENSON WASSERBECK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:NOAH
Authorized Official - Middle Name:B
Authorized Official - Last Name:ARENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:480-396-2781
Mailing Address - Street 1:4850 E BASELINE RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4625
Mailing Address - Country:US
Mailing Address - Phone:480-396-2781
Mailing Address - Fax:480-854-3094
Practice Address - Street 1:4850 E BASELINE RD
Practice Address - Street 2:SUITE 114
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4625
Practice Address - Country:US
Practice Address - Phone:480-396-2781
Practice Address - Fax:480-854-3094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ75736Medicare PIN