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Organization
VALLEY PHYSICAL THERAPY PS
Active
Organization
VALLEY PHYSICAL THERAPY PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKSIE K LARSON MPT (OWNER PRESIDENT)
(509) 758-5647
Entity
Organization
Contact information
Practice address
433 ELM STREET, CLARKSTON, WA 99403-2650
(509) 758-5647
(509) 758-5648
Mailing address
433 ELM STREET, CLARKSTON, WA 99403-2650
(509) 758-5647
(509) 758-5648
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00008466
WA
225100000X
Physical Therapist
PT1411
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805941300
—
ID
05
—
8379778
—
WA
Enumeration date
01/30/2007
Last updated
09/03/2014
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