Healthcare Provider Details

I. General information

NPI: 1255779732
Provider Name (Legal Business Name): RMTS ZILLAH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 1ST AVE
ZILLAH WA
98953-9432
US

IV. Provider business mailing address

513 1ST AVE
ZILLAH WA
98953-9432
US

V. Phone/Fax

Practice location:
  • Phone: 509-829-5230
  • Fax:
Mailing address:
  • Phone: 509-829-5230
  • Fax: 509-829-5269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMANDA CARNINE
Title or Position: OWNER
Credential: PT
Phone: 406-531-5918