Provider Demographics
NPI:1730491259
Name:BACK TO WORK PREVENTION & PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:BACK TO WORK PREVENTION & PHYSICAL THERAPY, INC.
Other - Org Name:RENEW PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:NORWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:206-501-6635
Mailing Address - Street 1:5620 RAINIER AVE S
Mailing Address - Street 2:SUITE #102
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1918
Mailing Address - Country:US
Mailing Address - Phone:206-535-8061
Mailing Address - Fax:
Practice Address - Street 1:5620 RAINIER AVE S STE 102
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2498
Practice Address - Country:US
Practice Address - Phone:206-535-8061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008773261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy