Provider Demographics
NPI:1407271216
Name:MOBILE PT LLC
Entity Type:Organization
Organization Name:MOBILE PT LLC
Other - Org Name:MOBILE PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:206-686-7300
Mailing Address - Street 1:26 ABBOTT RD
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:WA
Mailing Address - Zip Code:98541-9433
Mailing Address - Country:US
Mailing Address - Phone:206-686-7300
Mailing Address - Fax:206-686-7700
Practice Address - Street 1:26 ABBOTT RD
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:WA
Practice Address - Zip Code:98541-9433
Practice Address - Country:US
Practice Address - Phone:206-686-7300
Practice Address - Fax:206-686-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy