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General NPI Number Information
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NPI Number | 1154377240
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Entity Type | Organization
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Legal Business Name | ABC PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 2315 6TH AVE.
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City | TACOMA
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State | WA
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Zip | 98403-1050
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Country | US
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Telephone | 253-564-2220
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Fax | 253-564-2221
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Provider Business Mailing Address
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Address Line | 2315 6TH AVE.
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City | TACOMA
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State | WA
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Zip | 98403-1050
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Country | US
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Telephone | 253-564-2220
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Fax | 253-564-2221
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER NOEL FORD
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Credential | MPT
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Telephone | 253-564-2220
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT00006703
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License Number State | WA
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