Provider Demographics
NPI:1831337468
Name:FOOTWORKS PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:FOOTWORKS PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:206-632-4578
Mailing Address - Street 1:323 OCCIDENTAL AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2839
Mailing Address - Country:US
Mailing Address - Phone:206-632-4578
Mailing Address - Fax:206-299-0431
Practice Address - Street 1:323 OCCIDENTAL AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2839
Practice Address - Country:US
Practice Address - Phone:206-632-4578
Practice Address - Fax:206-299-0431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008453261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy