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General NPI Number Information
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NPI Number | 1306903182
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Entity Type | Organization
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Legal Business Name | DEER PARK PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 01/04/2013
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Provider Practice Location Address
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Address Line | 707 S PARK ST
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City | DEER PARK
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State | WA
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Zip | 99006-0948
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Country | US
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Telephone | 509-276-8811
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Fax | 866-629-4801
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Provider Business Mailing Address
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Address Line | 707 S PARK ST
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City | DEER PARK
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State | WA
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Zip | 99006-0948
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Country | US
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Telephone | 509-276-8811
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Fax | 866-629-4801
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Authorized Official
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Title or Position | OWNER
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Name | MR. DANIEL W ROBERTS
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Credential | P.T.
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Telephone | 509-276-8811
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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 | PT00002482
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License Number State | WA
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