Organization
NORTHLAND-RURAL THERAPY ASSOCIATES, LLC
Active
Other names
Northland-Rural Therapy Associates
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS COSNER PT (PHYSICAL THERAPIST, OWNER, DIRECTOR)
(928) 779-1679
Entity
Organization
Contact information
Practice address
2915 NORTH 4TH STREET, FLAGSTAFF, AZ 86004
(928) 779-1679
(928) 779-2822
Mailing address
2915 NORTH 4TH STREET, FLAGSTAFF, AZ 86004
(928) 779-1679
(928) 779-2822
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
872714
AHCCCS NUMBER
AZ
05
—
872714
—
AZ
Enumeration date
03/15/2007
Last updated
09/19/2022
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