Provider Demographics
NPI:1962846857
Name:STUDIO PILATES AND PHYSICAL THERAPY
Entity Type:Organization
Organization Name:STUDIO PILATES AND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:WALTHER
Authorized Official - Suffix:
Authorized Official - Credentials:P T
Authorized Official - Phone:509-413-2564
Mailing Address - Street 1:5915 S REGAL ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-6026
Mailing Address - Country:US
Mailing Address - Phone:509-413-2564
Mailing Address - Fax:509-242-3284
Practice Address - Street 1:5915 S REGAL ST
Practice Address - Street 2:SUITE 301
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-6026
Practice Address - Country:US
Practice Address - Phone:509-413-2564
Practice Address - Fax:509-242-3284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602664645225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty