Provider Demographics
NPI:1104199538
Name:GLOBAL PERFORMANCE SOLUTIONS PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:GLOBAL PERFORMANCE SOLUTIONS PHYSICAL THERAPY INC
Other - Org Name:GPS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:A
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:509-697-5330
Mailing Address - Street 1:304 S 1ST ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-2005
Mailing Address - Country:US
Mailing Address - Phone:509-697-5330
Mailing Address - Fax:509-697-5355
Practice Address - Street 1:304 S 1ST ST
Practice Address - Street 2:SUITE A
Practice Address - City:SELAH
Practice Address - State:WA
Practice Address - Zip Code:98942-2005
Practice Address - Country:US
Practice Address - Phone:509-697-5330
Practice Address - Fax:509-697-5355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-15
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010130261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy