Organization
CACTUS PHYSICAL THERAPY LIMITED, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD L. PAINCHAUD PH.D. (V.P./SECRETARY & STATUTORY AGENT)
(623) 465-7653
Entity
Organization
Contact information
Practice address
34155 N SCOTTSDALE RD, SCOTTSDALE, AZ 85262-1221
(480) 488-7018
(623) 465-7653
Mailing address
PO BOX 5914, CAREFREE, AZ 85377-5914
(623) 465-7653
(623) 465-7653
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
AZ #617
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19070617
I.C.A.
AZ
01
—
617
AZ PT
AR
01
—
AZ0088730
BCBS AZ
AZ
Enumeration date
07/28/2005
Last updated
08/22/2020
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