MEDICARE: BATTLE GROUND PHYSICAL THERAPY INC

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	:	1689665028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BATTLE GROUND PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	PO BOX 972
Second Line	:
City	:	BATTLE GROUND
State	:	WA
Zip	:	98604-0972
Country	:	US
Telephone Number	:	360-687-7147
Fax Number	:

Provider Business Practice Location Address
First Line	:	2312 W MAIN ST
Second Line	:	#117
City	:	BATTLE GROUND
State	:	WA
Zip	:	98604-4234
Country	:	US
Telephone Number	:	360-687-7147
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SHAWN SILVERSON
Credential	:
Telephone Number	:	360-687-7147

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	01/08/2008

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