Provider Demographics
NPI:1932316346
Name:KBC INTREPID ENTERPRISES INC
Entity Type:Organization
Organization Name:KBC INTREPID ENTERPRISES INC
Other - Org Name:NEXT STEP PHYSICAL THERAPY & SPORTS PERFORMANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:B
Authorized Official - Last Name:CALARA
Authorized Official - Suffix:
Authorized Official - Credentials:MS,PT
Authorized Official - Phone:206-283-1030
Mailing Address - Street 1:PO BOX 70601
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98127-0601
Mailing Address - Country:US
Mailing Address - Phone:206-283-1030
Mailing Address - Fax:206-283-1040
Practice Address - Street 1:1818 WESTLAKE AVE N STE 201
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2707
Practice Address - Country:US
Practice Address - Phone:206-283-1030
Practice Address - Fax:206-283-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602562899261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy