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Contact Information

ETHAN ANDERSON, DPT
7707 W DEER VALLEY RD
SUITE 100
PEORIA, AZ85382-2101
 Phone: 623-376-9100
 Fax: 623-376-9141
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Orthopedic

2251X0800X 65 Physical Therapist in Private Practice
 

Sports

2251S0007X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for ETHAN ANDERSON · (Male)

NPI # 1063966554
Status Active
Credentials DPT (Doctorate of Physical Therapy)
Entity Individual
Enumeration date 08/12/2016
Last updated 08/12/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 12383
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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