Provider Demographics
NPI:1437349198
Name:PREMIER PHYSICAL REHABILITATION LLC
Entity Type:Organization
Organization Name:PREMIER PHYSICAL REHABILITATION LLC
Other - Org Name:PHYSIOCARE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-402-9772
Mailing Address - Street 1:17618 140TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072
Mailing Address - Country:US
Mailing Address - Phone:425-402-9772
Mailing Address - Fax:425-402-9443
Practice Address - Street 1:17618 140TH AVE NE
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072
Practice Address - Country:US
Practice Address - Phone:425-402-9772
Practice Address - Fax:425-402-9443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty