Provider Demographics
NPI:1902642713
Name:BACKUS, SARAH (DPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BACKUS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7171 W FOOTHILL DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-5810
Mailing Address - Country:US
Mailing Address - Phone:773-679-8848
Mailing Address - Fax:
Practice Address - Street 1:14575 N 83RD PL UNIT 2
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2926
Practice Address - Country:US
Practice Address - Phone:773-679-8848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ013248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist