Provider Demographics
NPI:1780920306
Name:UPTOWN PHYSICAL THERAPY
Entity type:Organization
Organization Name:UPTOWN PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:AERTS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-774-1534
Mailing Address - Street 1:637 H ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-5243
Mailing Address - Country:US
Mailing Address - Phone:360-774-1534
Mailing Address - Fax:
Practice Address - Street 1:637 H ST
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-5243
Practice Address - Country:US
Practice Address - Phone:360-774-1534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty