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Organization
WALLA WALLA PHYSICAL THERAPY CENTER APS
Active
Organization
WALLA WALLA PHYSICAL THERAPY CENTER APS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J CLARK PT (PHYSICAL THERAPIST/OWNER)
(509) 522-0114
Entity
Organization
Contact information
Practice address
275 W TIETAN ST, WALLA WALLA, WA 99362-4363
(509) 522-0114
(509) 522-9868
Mailing address
275 W TIETAN ST, WALLA WALLA, WA 99362-4363
(509) 522-0114
(509) 522-9868
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
601 755 670
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306849955
NPI MICHAEL J CLARK PT
WA
01
—
650011919
RAILROAD MEDICARE MIKE
WA
05
—
7082266
—
WA
05
—
8348476
—
WA
05
—
8462996
—
WA
01
—
8861197
MEDICARE
WA
01
—
CD4682
RAILROAD MED GROUP #
WA
Enumeration date
07/22/2006
Last updated
06/22/2023
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