Provider Demographics
NPI:1922715150
Name:NOMAD PHYSICAL THERAPY, P.S.
Entity Type:Organization
Organization Name:NOMAD PHYSICAL THERAPY, P.S.
Other - Org Name:NOMAD PHYSICAL THERAPY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZOIE
Authorized Official - Middle Name:RACHELLE
Authorized Official - Last Name:BAER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:585-417-0004
Mailing Address - Street 1:1106 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6806
Mailing Address - Country:US
Mailing Address - Phone:564-209-4144
Mailing Address - Fax:
Practice Address - Street 1:1106 22ND ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6806
Practice Address - Country:US
Practice Address - Phone:564-209-4144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1578161790OtherNPI