Provider Demographics
NPI:1881810521
Name:VALLEY REHAB PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:VALLEY REHAB PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:STANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-424-5215
Mailing Address - Street 1:1777 S BURLINGTON BLVD # 474
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-3223
Mailing Address - Country:US
Mailing Address - Phone:360-424-5215
Mailing Address - Fax:360-848-4169
Practice Address - Street 1:803 S 15TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4514
Practice Address - Country:US
Practice Address - Phone:360-424-5215
Practice Address - Fax:360-848-4169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty