Provider Demographics
NPI:1720123508
Name:SOUND BODY REHABILITATION, INC.
Entity Type:Organization
Organization Name:SOUND BODY REHABILITATION, INC.
Other - Org Name:SOUND BODY REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-769-5944
Mailing Address - Street 1:PO BOX 4733
Mailing Address - Street 2:
Mailing Address - City:SOUTH COLBY
Mailing Address - State:WA
Mailing Address - Zip Code:98384-0733
Mailing Address - Country:US
Mailing Address - Phone:360-769-5944
Mailing Address - Fax:360-769-5944
Practice Address - Street 1:4459 SE MILE HILL DR
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3908
Practice Address - Country:US
Practice Address - Phone:360-769-5944
Practice Address - Fax:360-769-5944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8854482Medicare ID - Type UnspecifiedGROUP NUMBER FOR PRACTICE