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Organization
ORTHOSPORT PHYSICAL THERAPY LLC
Active
Organization
ORTHOSPORT PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS DIANGELIS PT, DPT (OWNER)
(425) 670-9991
Entity
Organization
Contact information
Practice address
19217 36TH AVE W, SUITE 102, LYNNWOOD, WA 98036-5751
(425) 670-9991
(425) 670-9995
Mailing address
19217 36TH AVE W, SUITE 102, LYNNWOOD, WA 98036-5751
(425) 670-9991
(425) 670-9995
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
PT00002005
WA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
10/13/2006
Last updated
12/18/2015
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