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General NPI Number Information
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NPI Number | 1508086331
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Entity Type | Organization
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Legal Business Name | MTI PHYSICAL THERAPY TACOMA
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7800 PACIFIC AVE STE 8
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City | TACOMA
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State | WA
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Zip | 98408-7050
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Country | US
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Telephone | 253-471-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 7800 PACIFIC AVE STE 8
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City | TACOMA
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State | WA
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Zip | 98408-7050
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Country | US
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Telephone | 253-471-7200
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR PT
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Name | SUSAN STEPHAN
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Credential | PT
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Telephone | 253-471-7200
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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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