Organization
NOSSEK REHAB LLC
Active
Organization
NOSSEK REHAB LLC
Active
Other names
Payson Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT J NOSSEK PT (OWNER)
(928) 474-0429
Entity
Organization
Contact information
Practice address
405 W MAIN ST, SUITE D, PAYSON, AZ 85541-5333
(928) 474-0429
(928) 474-0199
Mailing address
405 W MAIN ST, SUITE D, PAYSON, AZ 85541-5333
(928) 474-0429
(928) 474-0199
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
AZ
235Z00000X
Speech-Language Pathologist
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000227851
CMDP
AZ
01
—
1004136
CIGNA
AZ
05
—
194960
—
AZ
01
—
64-00187
UHC
AZ
01
—
670821
ACN
AZ
01
—
AZ-1730-1201
PTP
AZ
01
—
AZ0293830
BCBS
AZ
Enumeration date
04/23/2007
Last updated
07/21/2022
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