Provider Demographics
NPI:1992482111
Name:GREENHALGH, MCKENZIE ANN (PT, DPT)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:ANN
Last Name:GREENHALGH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 E TRELLIS RD
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-3328
Mailing Address - Country:US
Mailing Address - Phone:979-571-2671
Mailing Address - Fax:
Practice Address - Street 1:37200 N GANTZEL RD STE 260
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-7387
Practice Address - Country:US
Practice Address - Phone:480-690-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33065225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist