Provider Demographics
NPI:1982200416
Name:HART PHYSICAL THERAPY
Entity Type:Organization
Organization Name:HART PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDEN/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTOKOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:320-766-2576
Mailing Address - Street 1:1197 BRIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LYNDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98264-1073
Mailing Address - Country:US
Mailing Address - Phone:320-766-2576
Mailing Address - Fax:
Practice Address - Street 1:223 E BAKERVIEW RD
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7757
Practice Address - Country:US
Practice Address - Phone:360-255-4207
Practice Address - Fax:360-756-2390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility