Organization
HIGH DESERT PHYSICAL THERAPY AND SPORTS REHABILITATION, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH M HARTNETT DPT (OWNER/P.T.)
(928) 289-4378
Entity
Organization
Contact information
Practice address
221 W SECOND ST, WINSLOW, AZ 86047-3564
(928) 289-4378
(928) 289-5116
Mailing address
221 W SECOND ST, WINSLOW, AZ 86047-3564
(928) 289-4378
(928) 289-5116
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1993
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094792
—
AZ
05
—
356263
—
AZ
05
—
788599
—
AZ
01
—
DA1420
RR MEDICARE
AZ
01
—
Z197326
MEDICARE UPIN
AZ
01
—
Z75082
MEDICARE UPIN
AZ
Enumeration date
01/24/2006
Last updated
07/19/2018
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