Provider Demographics
NPI:1053806950
Name:CORTINA, JULIET AMANDA (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:JULIET
Middle Name:AMANDA
Last Name:CORTINA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 W BASSWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-7625
Mailing Address - Country:US
Mailing Address - Phone:480-381-2768
Mailing Address - Fax:
Practice Address - Street 1:8607 E PECOS RD STE 116
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-6572
Practice Address - Country:US
Practice Address - Phone:480-500-1446
Practice Address - Fax:855-535-7130
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-30101225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist