Provider Demographics
NPI:1093080004
Name:JARAMILLO PHYSICAL THERAPY SERVICES
Entity Type:Organization
Organization Name:JARAMILLO PHYSICAL THERAPY SERVICES
Other - Org Name:CORNERSTONE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:JARAMILLO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, COMT
Authorized Official - Phone:509-954-2653
Mailing Address - Street 1:623 W GARLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-2956
Mailing Address - Country:US
Mailing Address - Phone:509-209-9488
Mailing Address - Fax:509-209-9489
Practice Address - Street 1:623 W GARLAND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-2956
Practice Address - Country:US
Practice Address - Phone:509-209-9488
Practice Address - Fax:509-209-9489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60308900011261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy