Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PERFORMANCE SPORTS AND SPINE PHYSICAL THERAPY PS
Active
Organization
PERFORMANCE SPORTS AND SPINE PHYSICAL THERAPY PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY ISMAIL (PRESIDENT)
(209) 353-1988
Entity
Organization
Contact information
Practice address
21525 HWY 410 E, SUITE B, BONNEY LAKE, WA 98391-4101
(253) 826-8520
(253) 826-8522
Mailing address
21525 HWY 410 E, SUITE B, BONNEY LAKE, WA 98391-4101
(253) 826-8520
(253) 826-8522
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/02/2009
Last updated
12/06/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up