MEDICARE: NORTHWEST PHYSICAL THERAPY CENTER

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1316144140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST PHYSICAL THERAPY CENTER

Provider Business Mailing Address
First Line	:	2712 E 39TH AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-4543
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2712 E 39TH AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-4543
Country	:	US
Telephone Number	:	509-435-6802
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN MICHAEL SCHRUTH
Credential	:
Telephone Number	:	509-435-6802

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	08/22/2020

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