Provider Demographics
NPI:1386894541
Name:HIMLER PHYSICAL THERAPY
Entity type:Organization
Organization Name:HIMLER PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PEER
Authorized Official - Middle Name:A
Authorized Official - Last Name:HIMLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:480-626-5634
Mailing Address - Street 1:10450 E RIGGS RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SUN LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-7759
Mailing Address - Country:US
Mailing Address - Phone:480-626-5634
Mailing Address - Fax:480-445-9322
Practice Address - Street 1:10450 E RIGGS RD STE 102
Practice Address - Street 2:
Practice Address - City:SUN LAKES
Practice Address - State:AZ
Practice Address - Zip Code:85248-7759
Practice Address - Country:US
Practice Address - Phone:480-626-5634
Practice Address - Fax:480-445-9322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6843261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ122319Medicare PIN