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General NPI Number Information
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NPI Number | 1457460123
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Entity Type | Organization
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Legal Business Name | ELLENSBURG PHYSICAL THERAPY CENTER INC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 10/24/2008
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Provider Practice Location Address
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Address Line | 707 N PEARL ST STE K
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City | ELLENSBURG
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State | WA
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Zip | 98926-2938
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Country | US
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Telephone | 509-962-2492
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Fax | 509-962-5836
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Provider Business Mailing Address
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Address Line | 4781 COVE ROAD
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City | ELLENSBURG
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State | WA
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Zip | 98926-9135
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Country | US
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Telephone | 509-962-3292
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRIS T DUNLOP
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Credential |
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Telephone | 509-962-3292
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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 | PT00003715
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License Number State | WA
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