Provider Demographics
NPI:1427488808
Name:WHEELS ON THE BUS PEDIATRIC THERAPY
Entity type:Organization
Organization Name:WHEELS ON THE BUS PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAROTTO
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:480-242-5903
Mailing Address - Street 1:13835 N. TATUM BLVD STE 9-429
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-5590
Mailing Address - Country:US
Mailing Address - Phone:480-242-5903
Mailing Address - Fax:602-633-1076
Practice Address - Street 1:13835 N. TATUM BLVD STE 9-429
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-5590
Practice Address - Country:US
Practice Address - Phone:480-242-5903
Practice Address - Fax:602-633-1076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3353251E00000X, 261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251E00000XAgenciesHome Health