Organization
LAKESIDE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY SCHNEIDER PT (MEMBER MNAGER)
(509) 891-0658
Entity
Organization
Contact information
Practice address
1512 N VERCLER RD, SUITE 1, SPOKANE VALLEY, WA 99216-1087
(509) 891-0658
Mailing address
PO BOX 3115, HAYDEN, ID 83835-3115
(208) 765-0805
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00007174
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7094345
—
WA
Enumeration date
11/22/2006
Last updated
08/28/2008
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