| Organization Name: | HAVASU PHYSICAL THERAPY |
| NPI Number: | 1134111529 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONNA GALE JONES (OWNER / SOLE PROPRIETOR) |
| Mailing Address: | 2126 Mcculloch Blvd N Ste 18 Lake Havasu City |
| State: | AZ US |
| Postal Code: | 864036742 |
| Phone Number: | 9288547676 |
| Fax Number: | 9288547676 |
| NPI Enumeration Date: | 08/22/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2169 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |