Organization
CLASSICAL PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER J COLLA PT (OWNER)
(602) 443-1030
Entity
Organization
Contact information
Practice address
4045 N 7TH ST, SUITE 220, PHOENIX, AZ 85014-4736
(602) 443-1030
(602) 443-1033
Mailing address
4045 N 7TH ST, SUITE 220, PHOENIX, AZ 85014-4736
(602) 443-1030
(602) 443-1033
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
782880
—
AZ
Enumeration date
05/21/2007
Last updated
08/22/2020
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