Provider Demographics
NPI:1679271068
Name:STENSON, ERIC DANIEL (PT)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:DANIEL
Last Name:STENSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3337 N MILLER RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6496
Mailing Address - Country:US
Mailing Address - Phone:480-687-2438
Mailing Address - Fax:
Practice Address - Street 1:3337 N MILLER RD STE 103
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6496
Practice Address - Country:US
Practice Address - Phone:480-687-2438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16146225100000X
AZ33301225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist