Provider Demographics
NPI:1467922781
Name:BEACHFRONT THERAPY CONSULTANTS LLC
Entity Type:Organization
Organization Name:BEACHFRONT THERAPY CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:G
Authorized Official - Last Name:GARLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:PT, LMT
Authorized Official - Phone:253-223-1829
Mailing Address - Street 1:3120 SOUNDVIEW DR W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-1612
Mailing Address - Country:US
Mailing Address - Phone:253-223-1829
Mailing Address - Fax:
Practice Address - Street 1:3120 SOUNDVIEW DR W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-1612
Practice Address - Country:US
Practice Address - Phone:253-223-1829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty