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Organization
WESTSIDE PHYSICAL THERAPY AND SPORTS MEDICINE INC PS
Active
Organization
WESTSIDE PHYSICAL THERAPY AND SPORTS MEDICINE INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN LAWRENCE BUTTS PHYSICAL THERAPIST (OWNER DIRECTOR)
(509) 966-8981
Entity
Organization
Contact information
Practice address
1213 S 40TH AVE, YAKIMA, WA 98908-3961
(509) 966-8981
(509) 966-2125
Mailing address
1213 S 40TH AVE, YAKIMA, WA 98908-3961
(509) 966-8981
(509) 966-2125
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
600-454-078
WA
225X00000X
Occupational Therapist
600-454-078
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0148298
DEPT OF L & I
WA
05
—
7682842
—
WA
Enumeration date
08/16/2005
Last updated
12/30/2011
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