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General NPI Number Information
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NPI Number | 1982721874
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Entity Type | Organization
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Legal Business Name | INDEPENDENT PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 21 NE ROMANCE HILL RD STE 101
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City | BELFAIR
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State | WA
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Zip | 98528
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Country | US
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Telephone | 360-275-6612
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Fax | 360-275-6658
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Provider Business Mailing Address
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Address Line | PO BOX 457
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City | BELFAIR
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State | WA
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Zip | 98528-0457
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Country | US
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Telephone | 360-275-6612
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Fax | 360-275-6658
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Authorized Official
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Title or Position | OFFICE MGR
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Name | MRS. SHANIA MARSH
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Credential |
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Telephone | 360-275-6612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | 00002504
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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 | PT00007051
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License Number State | WA
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