Provider Demographics
NPI:1356462675
Name:BATTLE GROUND PHYSICAL THERAPY
Entity type:Organization
Organization Name:BATTLE GROUND PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:H
Authorized Official - Last Name:BARTEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-687-7147
Mailing Address - Street 1:PO BOX 972
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-0972
Mailing Address - Country:US
Mailing Address - Phone:360-887-7147
Mailing Address - Fax:
Practice Address - Street 1:2 SOUTH 56TH PLACE
Practice Address - Street 2:SUITE 100
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642
Practice Address - Country:US
Practice Address - Phone:360-887-7147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB09284Medicare ID - Type Unspecified