Provider Demographics
NPI:1497793590
Name:PHYSIOTHERAPY ASSOCIATES INC
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIGENFUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-685-7227
Mailing Address - Street 1:1004 W JAMES ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-4316
Mailing Address - Country:US
Mailing Address - Phone:253-852-3194
Mailing Address - Fax:253-852-2884
Practice Address - Street 1:1004 W JAMES ST
Practice Address - Street 2:SUITE 101
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-4316
Practice Address - Country:US
Practice Address - Phone:253-852-3194
Practice Address - Fax:253-852-2884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA34780OtherLABOR & INDUSTRIES
WA7064751Medicaid
WA7064751Medicaid