Basic Information
| Provider Information | |||||||||
| NPI: | 1093947012 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WEST GARLAND PHYSICAL THERAPY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1403 W GARLAND AVE # 1403 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992052619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093252992 | ||||||||
| FaxNumber: | 5093265112 | ||||||||
| Practice Location | |||||||||
| Address1: | 1403 W GARLAND AVE # 1403 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992052619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093252992 | ||||||||
| FaxNumber: | 5093265112 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2009 | ||||||||
| LastUpdateDate: | 08/10/2009 | ||||||||
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| AuthorizedOfficialLastName: | SCHELL | ||||||||
| AuthorizedOfficialFirstName: | DAWNITTA | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5093251977 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.