1730467960 NPI number — MISS JENNA LEIGH SALBER PT, DPT

Table of content: MISS JENNA LEIGH SALBER PT, DPT (NPI 1730467960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730467960 NPI number — MISS JENNA LEIGH SALBER PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALBER
Provider First Name:
JENNA
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1730467960
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14287 N 87TH ST STE 220
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85260-3698
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-551-4961
Provider Business Mailing Address Fax Number:
480-860-0165

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16611 S 40TH ST
Provider Second Line Business Practice Location Address:
STE. 130
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85048-0562
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-706-1199
Provider Business Practice Location Address Fax Number:
480-706-3999
Provider Enumeration Date:
07/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  9360 , 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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