Provider Demographics
NPI:1881429850
Name:FASCIAL CONNECTIONS PT, LLC
Entity type:Organization
Organization Name:FASCIAL CONNECTIONS PT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:FISCHBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:360-770-4164
Mailing Address - Street 1:4292 TURNER RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55803-9258
Mailing Address - Country:US
Mailing Address - Phone:360-770-4164
Mailing Address - Fax:
Practice Address - Street 1:4292 TURNER RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55803-9258
Practice Address - Country:US
Practice Address - Phone:360-770-4164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy