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General NPI Number Information
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NPI Number | 1194943381
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Entity Type | Organization
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Legal Business Name | ADULT REHABILITATION THERAPIES, PLLC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 31200 23RD AVE SOUTH SUITE 100
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City | FEDERAL WAY
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State | WA
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Zip | 98003
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Country | US
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Telephone | 253-839-3403
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Fax | 253-839-3412
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Provider Business Mailing Address
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Address Line | PO BOX 6225
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City | FEDERAL WAY
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State | WA
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Zip | 98063
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Country | US
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Telephone | 253-839-3403
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Fax | 253-839-3412
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES C FULLER
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Credential | PHYSICAL THERAPIST
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Telephone | 253-839-3403
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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 | 602023026
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License Number State | WA
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