Healthcare Provider Details

I. General information

NPI: 1689665028
Provider Name (Legal Business Name): BATTLE GROUND PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 W MAIN ST #117
BATTLE GROUND WA
98604-4234
US

IV. Provider business mailing address

PO BOX 972
BATTLE GROUND WA
98604-0972
US

V. Phone/Fax

Practice location:
  • Phone: 360-687-7147
  • Fax:
Mailing address:
  • Phone: 360-687-7147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SHAWN SILVERSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 360-687-7147