Provider Demographics
NPI:1316969603
Name:ORSO, EVA KARIN (PT)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:KARIN
Last Name:ORSO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1566 E AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-6831
Mailing Address - Country:US
Mailing Address - Phone:602-438-9773
Mailing Address - Fax:602-438-9776
Practice Address - Street 1:3230 E BASELINE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-7133
Practice Address - Country:US
Practice Address - Phone:602-438-9773
Practice Address - Fax:602-438-9776
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6608225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZQ28132Medicare UPIN
AZ10126Medicare ID - Type Unspecified