Organization Name: | SOUTH WHIDBEY PHYSICAL THERAPY AND SPORTS CLINIC |
NPI Number: | 1306947841 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANDREW J. GOETZ (OWNER, THERAPIST) |
Mailing Address: | 5522 Freeland Ave Freeland |
State: | WA US |
Postal Code: | 982499734 |
Phone Number: | 3603315272 |
Fax Number: | 3603315848 |
NPI Enumeration Date: | 09/26/2006 |
NPI Last Update Date: | 02/11/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 601918262 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |