| Organization Name: | MIKRUT PHYSICAL THERAPY LLC |
| NPI Number: | 1649223306 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES MIKRUT (OWNER/PRESIDENT) |
| Mailing Address: | 13175 E Highway 169 Dewey |
| State: | AZ US |
| Postal Code: | 863277372 |
| Phone Number: | 9286320800 |
| Fax Number: | 9286328505 |
| NPI Enumeration Date: | 05/17/2006 |
| NPI Last Update Date: | 03/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 5501005426 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |