Provider Demographics
NPI:1689440554
Name:PRECARE PHYSIOTHERAPY AND CONSULTING SERVICES LLC
Entity Type:Organization
Organization Name:PRECARE PHYSIOTHERAPY AND CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMANTOC
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:971-237-0772
Mailing Address - Street 1:633 W HORTON WAY APT 222
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-7337
Mailing Address - Country:US
Mailing Address - Phone:360-389-3156
Mailing Address - Fax:855-798-1869
Practice Address - Street 1:2227 QUEEN ST STE 3
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-4765
Practice Address - Country:US
Practice Address - Phone:360-389-3156
Practice Address - Fax:855-978-1869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty