| Organization Name: | PERFORMANCE SPORTS AND SPINE PHYSICAL THERAPY PS |
| NPI Number: | 1093957292 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PETER L ERICKSON (PHYSICAL THERAPIST) |
| Mailing Address: | 21525 Hwy 410 E Suite B Bonney Lake |
| State: | WA US |
| Postal Code: | 983914101 |
| Phone Number: | 2538268520 |
| Fax Number: | 2538268522 |
| NPI Enumeration Date: | 04/02/2009 |
| NPI Last Update Date: | 04/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |