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General NPI Number Information
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NPI Number | 1255147336
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Entity Type | Organization
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Legal Business Name | HIGHLINE PHYSICAL THERAPY GROUP
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 20910 STATE ROUTE 410 E
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City | BONNEY LAKE
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State | WA
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Zip | 98391-6302
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Country | US
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Telephone | 253-862-2575
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Fax | 253-862-2675
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Provider Business Mailing Address
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Address Line | 2600 DALLAS PKWY STE 290
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City | FRISCO
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State | TX
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Zip | 75034-7493
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Country | US
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Telephone | 945-260-0010
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Fax |
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Authorized Official
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Title or Position | COO
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Name | ROBERT PACE
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Credential |
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Telephone | 213-804-1712
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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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