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General NPI Number Information
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NPI Number | 1245746973
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Entity Type | Organization
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Legal Business Name | FORCE 10 PERFORMANCE (REDMOMND), LLC
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Dates
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Enumeration Date | 12/18/2017
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Last Update Date | 02/08/2018
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Provider Practice Location Address
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Address Line | 17935 NE 65TH ST
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City | REDMOND
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State | WA
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Zip | 98052-4925
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Country | US
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Telephone | 425-867-5330
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Fax |
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Provider Business Mailing Address
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Address Line | 17935 NE 65TH ST
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City | REDMOND
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State | WA
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Zip | 98052-4925
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Country | US
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Telephone | 425-867-5330
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | TOM SPENCER
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Credential |
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Telephone | 425-867-5330
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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 | WA
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