Healthcare Provider Details

I. General information

NPI: 1083746622
Provider Name (Legal Business Name): APPLE PHYSICAL THERAPY PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 12/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 LIMITED LN NW SUITE B
OLYMPIA WA
98502-2638
US

IV. Provider business mailing address

790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US

V. Phone/Fax

Practice location:
  • Phone: 360-709-0700
  • Fax: 360-709-0703
Mailing address:
  • Phone: 630-296-2223
  • Fax: 630-759-9510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LYNN MCGIVERN
Title or Position: COO
Credential:
Phone: 630-296-2222