Provider Demographics
NPI:1073025490
Name:PHYSIOSTRENGTH LLC
Entity Type:Organization
Organization Name:PHYSIOSTRENGTH LLC
Other - Org Name:PHYSIOSTRENGTH PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONNOR
Authorized Official - Middle Name:LAVANN
Authorized Official - Last Name:NACCARATO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:253-336-2040
Mailing Address - Street 1:2909 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2540
Mailing Address - Country:US
Mailing Address - Phone:253-336-2040
Mailing Address - Fax:
Practice Address - Street 1:2909 S 12TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2540
Practice Address - Country:US
Practice Address - Phone:253-722-9788
Practice Address - Fax:253-778-6992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty