Organization
FOOTHILLS SPORTS MEDICINE & REHABILITATION - GRAYHAWK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BASTEN PT (OWNER)
(480) 689-5515
Entity
Organization
Contact information
Practice address
21811 N SCOTTSDALE RD, SUTE 120, SCOTTSDALE, AZ 85255-7441
(480) 706-1161
(480) 706-7997
Mailing address
21811 N SCOTTSDALE RD, SUTE 120, SCOTTSDALE, AZ 85255-7441
(480) 706-1161
(480) 706-7997
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
05/04/2007
Last updated
05/05/2022
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