MEDICARE: SYNERGY HEALTHCARE 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	261QP2000X	Physical Therapy Clinic/Center
2	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780741439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNERGY HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	12012 E MISSION AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-4887
Country	:	US
Telephone Number	:	509-444-8383
Fax Number	:	509-413-1673

Provider Business Practice Location Address
First Line	:	12012 E MISSION AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-4887
Country	:	US
Telephone Number	:	509-444-8383
Fax Number	:	509-413-1673

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	KELLI ANDERSON
Credential	:
Telephone Number	:	509-413-1630

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	12/17/2019

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Directions to “SYNERGY HEALTHCARE INC. ” Practice Location

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