Provider Demographics
NPI:1427468255
Name:KRIESE, DENISE SPRACKLEN (PT,)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:SPRACKLEN
Last Name:KRIESE
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 1:333 W INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3205
Mailing Address - Country:US
Mailing Address - Phone:602-776-9000
Mailing Address - Fax:602-776-9001
Practice Address - Street 1:333 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3205
Practice Address - Country:US
Practice Address - Phone:602-776-9000
Practice Address - Fax:602-776-9001
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2215225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist