MEDICARE: UPTOWN PHYSICAL THERAPY

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	:	1780920306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPTOWN PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	637 H ST
Second Line	:
City	:	PORT TOWNSEND
State	:	WA
Zip	:	98368-5243
Country	:	US
Telephone Number	:	360-774-1534
Fax Number	:

Provider Business Practice Location Address
First Line	:	637 H ST
Second Line	:
City	:	PORT TOWNSEND
State	:	WA
Zip	:	98368-5243
Country	:	US
Telephone Number	:	360-774-1534
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SALLY MARIE AERTS
Credential	:	P.T.
Telephone Number	:	360-774-1534

Provider Enumeration Date	:	12/31/2012
Last Update Date	:	12/31/2012

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Directions to “UPTOWN PHYSICAL THERAPY ” Practice Location

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