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Organization

JERRY M JOHNSON ETAL PTR FOUR SEASONS PHYSICAL THERAPY

Active
Other names
Four Seasons Physical Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JERRY MICHAEL JOHNSON PT (ADMINISTRATIVE DIRECTOR)
(509) 327-1578
Entity
Organization

Contact information

Practice address
1111 W WELLESLEY AVE, SPOKANE, WA 99205-1274
(509) 327-1578
(509) 327-1596
Mailing address
1111 W WELLESLEY AVE, SPOKANE, WA 99205-1274
(509) 327-1578
(509) 327-1596

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
601871376
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7116312
WA
Enumeration date
12/01/2005
Last updated
12/31/2012
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