1558950345 NPI number — UNIQUE PRINTS PEDIATRIC THERAPY SERVICES INC

Table of content: (NPI 1558950345)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558950345 NPI number — UNIQUE PRINTS PEDIATRIC THERAPY SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIQUE PRINTS PEDIATRIC THERAPY SERVICES INC
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:
Provider Other Organization Name Type Code:
6
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:
1558950345
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21045 N 9TH PL STE 204
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85024-5635
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-726-2300
Provider Business Mailing Address Fax Number:
602-726-2322

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9830 W 59TH PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARVADA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80004-5013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-773-1034
Provider Business Practice Location Address Fax Number:
303-773-1977
Provider Enumeration Date:
01/15/2021

Additional Information

Authorized Official

Authorized Official Last Name:
SHERMAN
Authorized Official First Name:
RYAN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
602-319-7324

Provider Taxonomy Codes

  • Taxonomy code: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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