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Contact Information

360 PHYSICAL THERAPY LLC
11340 W BELL RD
SURPRISE, AZ85378-9342
 Phone: 623-226-6644
 Fax: 623-522-4042
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for 360 PHYSICAL THERAPY LLC

NPI Number 1386318699
LBN Legal business name 360 PHYSICAL THERAPY LLC
Authorized official CHERYL BRUNIN - (VP OF REVENUE MANAGEMENT)
Entity Organization
Organization subpart 1 Yes
Enumeration date 08/02/2021
Last updated 12/17/2021 - About 4 years ago
Identifiers
AZ Medicaid 300502
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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