Healthcare Provider Details
I. General information
NPI: 1659346153
Provider Name (Legal Business Name): CENTRAL PHYSICAL THERAPY AND FITNESS, P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2006
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1917 FIR ST
PORT TOWNSEND WA
98368-3515
US
IV. Provider business mailing address
1917 FIR ST
PORT TOWNSEND WA
98368-3515
US
V. Phone/Fax
- Phone: 206-860-3746
- Fax:
- Phone: 206-860-3746
- Fax: 360-344-2248
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEBORAH
M
SCHAACK
Title or Position: BUSINESS MGR AND SEC TREAS OF CORP
Credential:
Phone: 206-860-3746