Healthcare Provider Details
I. General information
NPI: 1992837553
Provider Name (Legal Business Name): APPLE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/09/2007
Last Update Date: 12/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3315 S 23RD ST SUITE 210
TACOMA WA
98405-1605
US
IV. Provider business mailing address
790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US
V. Phone/Fax
- Phone: 253-572-8684
- Fax: 253-284-0450
- Phone: 630-296-2223
- Fax: 630-759-9510
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LYNN
MCGIVERN
Title or Position: COO
Credential:
Phone: 630-296-2222