Organization
MAKING MILESTONES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY DYKSTRA PT, DPT (PHYSICAL THERAPIST/PRESIDENT)
(602) 295-9679
Entity
Organization
Contact information
Practice address
3310 E CANARY WAY, CHANDLER, AZ 85286-5682
(602) 295-9679
(480) 361-9838
Mailing address
3310 E CANARY WAY, CHANDLER, AZ 85286-5682
(602) 295-9679
(480) 361-9838
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6132
AZ
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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