Black Ridge Physical Therapy, Plc

LBN: Black Ridge Physical Therapy, Plc
Black Ridge Physical Therapy, Plc is an health care organization with primary practice located at 80 S 13Th West , Saint Johns AZ 85936. The organization recently has only one registered license in Ambulatory Health Care Facilities / Physical Therapy, which is considered as the primary health care specialty. Black Ridge Physical Therapy, Plc can be contacted via phone (928) 337-3020, or through Wiltbank, Carl S via phone (928) 337-3020.

Contact Information

Primary practice address
80 S 13Th West Saint Johns AZ 85936
Phone: (928) 337-3020
Fax: (928) 337-3979
Website:
Map and Directions
Authorized official contact:
Name: Wiltbank, Carl S DPT
Phone: (928) 337-3020

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X 8544 Arizona

Profile Details

NPI number 1649698945
LBN Legal business name Black Ridge Physical Therapy, Plc
DBA Doing business as
Authorized official Wiltbank, Carl S DPT
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2014
Last updated Jun 16th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649698945 NPPES
Arizona MEDICAID 443777
Arizona Other Z131189

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