Organization
PREMIER PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK S PURCELL PT (OWNER)
(360) 636-4360
Entity
Organization
Contact information
Practice address
1118 14TH AVE, LONGVIEW, WA 98632-3017
(360) 636-4360
(360) 425-5250
Mailing address
118 14TH AVE, LONGVIEW, WA 98632-3017
(360) 636-4360
(360) 425-5250
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0162-456
DEPARTMENT OF L&I
WA
05
—
7072861
—
WA
Enumeration date
05/21/2007
Last updated
08/12/2010
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