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Individual

JACOB R HYATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
20950 N TATUM BLVD, SUITE100, PHOENIX, AZ 85050-4200
(480) 502-5510
(480) 538-4862
Mailing address
9097 E DESERT COVE AVE, SUITE 110, SCOTTSDALE, AZ 85260-6710
(480) 860-4298
(480) 860-0356

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8985
AZ
225700000X
Massage Therapist
MT12341
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8985
PT LICENSE
AZ
Enumeration date
08/18/2010
Last updated
03/12/2013
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