Provider Demographics
NPI:1114701745
Name:INVICTUS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:INVICTUS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEEBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:503-739-5198
Mailing Address - Street 1:3620 S CHESIN DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-3311
Mailing Address - Country:US
Mailing Address - Phone:503-739-5198
Mailing Address - Fax:
Practice Address - Street 1:3620 S CHESIN DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-3311
Practice Address - Country:US
Practice Address - Phone:503-739-5198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty