Organization
JEFF KITCHEN, INC.
Active
Other names
Rehab Plus Sports Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTI DAWN KITCHEN PTA (OFFICE MANAGER)
(480) 415-0444
Entity
Organization
Contact information
Practice address
10121 E BELL RD, SUITE 140, SCOTTSDALE, AZ 85260-2187
(480) 419-3500
(480) 419-3522
Mailing address
PO BOX 18607, FOUNTAIN HILLS, AZ 85269-8607
(480) 415-0444
(480) 419-3522
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
AZ2214
AZ
2251S0007X
Sports Physical Therapist
AZ2214
AZ
2251X0800X
Orthopedic Physical Therapist
AZ2214
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0461600
BCBS AZ NUMBER
AZ
01
—
2Z0057
HEALTHNET PROVIDER NUMBER
AZ
01
—
7228691
AETNA PROVIDER NUMBER
AZ
05
—
969371
—
AZ
Enumeration date
04/26/2007
Last updated
01/22/2019
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