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Organization

HIGH DESERT PHYSICAL THERAPY AND SPORTS REHABILITATION, PLLC

Active
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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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