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General NPI Number Information
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NPI Number | 1538823455
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Entity Type | Organization
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Legal Business Name | ISLAND MOBILE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/27/2021
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 10858 FALK RD NE
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-3311
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Country | US
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Telephone | 206-462-8893
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Fax |
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Provider Business Mailing Address
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Address Line | 10858 FALK RD NE
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-3311
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY/OWNER
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Name | LAURA TOWLE
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Credential | DPT
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Telephone | 206-462-8893
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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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