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General NPI Number Information
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NPI Number | 1124457387
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Entity Type | Organization
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Legal Business Name | CANYON VIEW PHYSICAL THERAPY
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Dates
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Enumeration Date | 11/07/2013
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 100 E JACKSON AVE SUITE 201
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City | ELLENSBURG
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State | WA
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Zip | 98926-3692
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Country | US
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Telephone | 509-925-6220
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Fax | 509-925-6221
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Provider Business Mailing Address
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Address Line | 100 E JACKSON AVE SUITE 201
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City | ELLENSBURG
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State | WA
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Zip | 98926-3692
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Country | US
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Telephone | 509-925-6220
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Fax | 509-925-6221
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Authorized Official
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Title or Position | OWNER
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Name | NATALIE K JOYCE
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Credential | MPT
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Telephone | 509-925-6220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT00008679
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License Number State | WA
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