Doctor Name: | KIRSTEN FOGARTY |
NPI Number: | 1194173666 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T D.P.T. |
License Number: | 12190 |
Business Practice Address: | 3035 S Ellsworth Rd Bldg 4 Ste 128 Mesa, AZ - 852122160 |
Business Phone Number: | 4803576500 |
Business Fax Number: | 4803576515 |
Mailing Address: | 3050 N Litchfield Rd, Ste 100 GOODYEAR |
State: | AZ |
Postal Code: | 853957804 |
Phone Number: | 6239355505 |
Fax Number: | 6239355551 |
NPI Enumeration Date: | 05/25/2016 |
NPI Last Update Date: | 05/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 12190 |
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 |