| Organization Name: | ULTIMATE PERFORMANCE REHABILITATION LLC |
| NPI Number: | 1013175744 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MEGAN MARIE MILYARD (OWNER/OCCUPATIONAL THERAPIST) |
| Mailing Address: | 19351 8th Ave Ne Suite 200 Poulsbo |
| State: | WA US |
| Postal Code: | 983708710 |
| Phone Number: | 3606973003 |
| Fax Number: | 3606973026 |
| NPI Enumeration Date: | 05/29/2008 |
| NPI Last Update Date: | 11/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | OT00002325 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |