Provider Demographics
NPI:1922343219
Name:PARKWAY PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:PARKWAY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:F.
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:BEMIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-433-9333
Mailing Address - Street 1:230 REGIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-5942
Mailing Address - Country:US
Mailing Address - Phone:618-433-9333
Mailing Address - Fax:618-433-9663
Practice Address - Street 1:230 REGIONAL DR
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5942
Practice Address - Country:US
Practice Address - Phone:618-433-9333
Practice Address - Fax:618-433-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty