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Individual

PHILIP PACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1972 E BASELINE RD STE 102, TEMPE, AZ 85283-1532
(480) 730-0501
Mailing address
3941 E CODY AVE, GILBERT, AZ 85234-3005
(908) 894-0614

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-31866
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPT-31866
ARIZONA STATE BOARD OF PHYSICAL THERAPY
AZ
Enumeration date
07/26/2021
Last updated
07/26/2021
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