Doctor Name: | DAVID S KISICKI |
NPI Number: | 1184670598 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 5621 |
Business Practice Address: | 6520 W Happy Valley Rd Ste B 109 Glendale, AZ - 853102615 |
Business Phone Number: | 6235611300 |
Business Fax Number: | 6235610036 |
Mailing Address: | 6520 W Happy Valley Rd, Ste B 109 GLENDALE |
State: | AZ |
Postal Code: | 853102615 |
Phone Number: | 6235611300 |
Fax Number: | 6235610036 |
NPI Enumeration Date: | 05/26/2006 |
NPI Last Update Date: | 06/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5621 |
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 |