Organization
FRONTIER THERAPY LLC
Active
Other names
Kitsap Physical Therapy and Sports Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ROBERT CARLSON PT (OWNER)
(360) 895-9090
Entity
Organization
Contact information
Practice address
1880 POTTERY AVE, STE 100, PORT ORCHARD, WA 98366-2518
(360) 895-9090
(360) 895-9089
Mailing address
1880 POTTERY AVE, STE 100, PORT ORCHARD, WA 98366
(360) 895-9090
(360) 895-9089
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0150495
WA DEPT OF LNI
WA
05
—
7105166
—
WA
Enumeration date
06/23/2006
Last updated
10/17/2007
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