OrganizationSelf Solace Physical Therapy, IncPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address16515 S 40th St, Suite 133, Phoenix, AZ 85048-0558(480) 704-6133(602) 206-8261PECOS EnrollmentBased on the most recent information from CMS, provider Self Solace Physical Therapy, Inc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 15 days ago.Profile DetailsProvider ID1962649293Provider TypeOrganizationFull NameSelf Solace Physical Therapy, IncSubpartNoEnumeration Date1/8/2009Last Updated1/8/2009Contact InformationPractice LocationPractice Address16515 S 40th St, Suite 133, Phoenix, AZ 85048-0558Phone(480) 704-6133FaxUnlisted FaxMailing LocationMailing Address16044 S 18th Ave, Phoenix, AZ 85045-1752Phone(602) 206-8261FaxUnlisted FaxAuthorized OfficialNameStickle, Christina (Billing Manager)Phone(480) 993-5993Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense6572Arizona