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General NPI Number Information
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NPI Number | 1457878035
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Entity Type | Organization
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Legal Business Name | SUMNER SPECIALIZED PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 212 W BIRCH AVE
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City | COLVILLE
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State | WA
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Zip | 99114-2440
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Country | US
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Telephone | 509-684-5621
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Fax | 509-684-7943
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Provider Business Mailing Address
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Address Line | 212 W BIRCH AVE
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City | COLVILLE
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State | WA
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Zip | 99114-2440
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Country | US
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Telephone | 509-684-5621
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Fax | 509-684-7943
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Authorized Official
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Title or Position | OWNER/DPT
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Name | ROBERT DAVID SUMNER
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Credential | DPT
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Telephone | 509-684-5621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT00010199
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT00010199
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License Number State | WA
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