MEDICARE: GREGORY J. HELGATH, INC. PS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	PT00009976	WA

General Provider Information

NPI Number	:	1265573844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY J. HELGATH, INC. PS

Provider Business Mailing Address
First Line	:	210 THIRD ST.
Second Line	:
City	:	LYNDEN
State	:	WA
Zip	:	98264-1411
Country	:	US
Telephone Number	:	360-354-3030
Fax Number	:	360-354-1013

Provider Business Practice Location Address
First Line	:	210 THIRD ST.
Second Line	:
City	:	LYNDEN
State	:	WA
Zip	:	98264-1411
Country	:	US
Telephone Number	:	360-354-3030
Fax Number	:	360-354-1013

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GREGORY J HELGATH
Credential	:	PT
Telephone Number	:	360-354-3030

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	09/16/2013

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