Provider Demographics
NPI:1861538522
Name:JAMES M TROUT MPT & ASSOCIATES PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:JAMES M TROUT MPT & ASSOCIATES PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:TROUT
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:520-648-0270
Mailing Address - Street 1:50 E DUVAL RD STE 10
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-4153
Mailing Address - Country:US
Mailing Address - Phone:520-648-0270
Mailing Address - Fax:520-625-5065
Practice Address - Street 1:50 E DUVAL RD STE 10
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-4153
Practice Address - Country:US
Practice Address - Phone:520-648-0270
Practice Address - Fax:520-625-5065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ105935OtherPROVIDER PIN #
AZZ105934OtherGROUP PIN #
AZ6100OtherPHYSICAL THERAPIST LIC. #