1831568385 NPI number — ONE ACCORD PT GILBERT PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831568385 NPI number — ONE ACCORD PT GILBERT PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONE ACCORD PT GILBERT PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ONE ACCORD PHYSICAL THERAPY GILBERT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831568385
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4365 E PECOS RD
Provider Second Line Business Mailing Address:
SUITE 140
Provider Business Mailing Address City Name:
GILBERT
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85295-8053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-331-7522
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4365 E PECOS RD
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
GILBERT
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85295-8053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-331-7522
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MCKINNON
Authorized Official First Name:
CORY
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR OF PHYSICAL THERAPY
Authorized Official Telephone Number:
480-202-9282

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  9491 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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