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General NPI Number Information
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NPI Number | 1740261791
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Entity Type | Organization
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Legal Business Name | LAKE CHELAN PHYSICAL THERAPY, PS
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 305 METHOW VALLEY HIGHWAY
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City | TWISP
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State | WA
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Zip | 98856
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Country | US
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Telephone | 509-997-4851
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Fax | 509-997-4852
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Provider Business Mailing Address
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Address Line | PO BOX 870
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City | TWISP
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State | WA
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Zip | 98856-0870
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Country | US
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Telephone | 509-997-4851
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Fax | 509-997-4852
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Authorized Official
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Title or Position | BOOKKEEPER
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Name | BRENDA TAYLOR
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Credential |
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Telephone | 509-682-4713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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