| Organization Name: | MOSES LAKE SPORTS PHYSICAL THERAPY, PS |
| NPI Number: | 1912022658 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RANDY C BRUCE (PHYSICAL THERAPIST) |
| Mailing Address: | 515 N Stratford Rd Moses Lake |
| State: | WA US |
| Postal Code: | 988371572 |
| Phone Number: | 5097664277 |
| Fax Number: | 5097664280 |
| NPI Enumeration Date: | 03/20/2007 |
| NPI Last Update Date: | 04/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT00005408 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| 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 |