FOOTHILLS SPORTS MEDICINE & PHYSICAL THERAPY - STETSON VILLAGE, LLC (NPI# 1700305596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700305596 |
| Entity Type | Organization |
| Organization Name | FOOTHILLS SPORTS MEDICINE & PHYSICAL THERAPY - STETSON VILLAGE, LLC |
| Practice Address |
3850 W Happy Valley Rd Ste 147149 Glendale AZ 85310-3280 |
| Mailing Address |
15410 S Mountain Pkwy Ste 112 Phoenix AZ 85044-6691 |
| Practice Telephone | 6233228925 |
| Practice Fax Number | 6234448336 |
| Mailing Telephone | 4807061161 |
| Mailing Fax Number | 4807067997 |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2020-03-05 |
| Authorized Official Name | MICHAEL BASTEN (OWNER) |
| Authorized Official Telephone | 4806895515 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
3850 W HAPPY VALLEY RD STE 147149 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85310-3280 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316597479 | Diana Olp | Technician | 5003 W. Creedance Blvd., Glendale, AZ 85310 | 2019-09-19 |
| 1972091940 | Daniel Hamilton | Physician Assistant | 4946 W Electra Ln, Glendale, AZ 85310 | 2018-04-25 |
| 1265958615 | Rose Ilene Wesol | Registered Nurse | Copper Creek Elementary School, 7071 W Hillcrest Blvd, Glendale, AZ 85310 | 2017-08-17 |
| 1730510785 | Otilia Muresan | Preferred Provider Organization | 22365 N 69th Ave, Glendale, AZ 85310 | 2013-12-02 |
| 1811129026 | Hope Healthcare, LLC | Home Health | 6022 W Robin Ln, Glendale, AZ 85310 | 2009-08-20 |
| 1467699777 | Desert Winds Behavioral Health LLC | Case Management | 6127 W. Westwind Dr., Glendale, AZ 85310 | 2009-01-08 |
| 1083835235 | Amy Marie Mccluer | Occupational Therapy Assistant | 7071 W. Hillcrest Blvd., Glendale, AZ 85310 | 2007-05-02 |
| 1346364866 | Camelia Igna | Assisted Living Facility | 6127 W Westwind Dr, Glendale, AZ 85310 | 2007-03-19 |
| 1124185228 | Daas Healthcare, LLC | Internal Medicine | 19841 N.27th Ave, Suite 300, Phoenix, AZ 85310 | 2007-01-02 |
| 1467545160 | Rgl Development, LLC | Assisted Living Facility | 6735 West Hillcrest Blvd, Glendale, AZ 85310 | 2006-10-02 |
| Find all providers in zip 85310 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730787094 | Movement System Institute Physiotherapy Inc | Clinic/Center | 508 Glenwood Rd Apt 102, Glendale, CA 91202-1572 | 2020-10-09 |
| 1265072904 | Wyatt Robert Wichman | Clinic/Center | 100 W Broadway Ste 750, Glendale, CA 91210-1215 | 2020-01-10 |
| 1902461312 | Mighty Oaks Therapy Pllc | Clinic/Center | 20329 N 59th Ave Ste A5, Glendale, AZ 85308-6854 | 2019-05-01 |
| 1003358607 | Aris Health Corp | Clinic/Center | 17100 N 67th Ave Bldg 1, Glendale, AZ 85308-3605 | 2016-11-14 |
| 1265808240 | Orthosports Physical Therapy | Clinic/Center | 5620 W Thunderbird Rd Ste B1, Glendale, AZ 85306-4638 | 2015-08-13 |
| 1306140801 | Annette Tamraz Physical Therapy Inc | Clinic/Center | 1000 N Central Ave Ste 220, Glendale, CA 91202-2957 | 2010-12-27 |
| 1952388639 | Pon Physical Therapy Inc | Clinic/Center | 1944 W Glenoaks Blvd, Glendale, CA 91201-1644 | 2005-12-23 |
| 1902375405 | Foothills Sports Medicine & Physical Therapy - Glendale LLC | Clinic/Center | 19420 N 59th Ave Ste H830, Glendale, AZ 85308-6980 | 2018-11-14 |
| 1093216624 | Bhsm Rehabilitation, LLC | Clinic/Center | 4344 W Bell Rd Ste 100, Glendale, AZ 85308-3589 | 2018-02-28 |
| 1215464185 | Revamp Physical Therapy, Inc | Clinic/Center | 805 E Broadway Ste A, Glendale, CA 91205-4527 | 2017-05-22 |
| Find all providers in GLENDALE | ||||
Please comment or provide details below to improve the information on FOOTHILLS SPORTS MEDICINE & PHYSICAL THERAPY - STETSON VILLAGE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.