Individual
MR. ROBERT COREY ADDICOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
20325 N 51ST AVE STE 150, GLENDALE, AZ 85308-4622
(602) 385-2115
(480) 418-3323
Mailing address
18444 N 25TH AVE, SUITE 310, PHOENIX, AZ 85023-1261
(623) 537-5600
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5198
AZ
2251S0007X
Sports Physical Therapist
5198
AZ
2251X0800X
Orthopedic Physical Therapist
Primary
5198
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113252
—
AZ
01
—
69799
MEDICARE
AZ
Enumeration date
05/27/2005
Last updated
08/10/2022
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