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Organization

AURORA VILLAGE PHYSICAL THERAPY, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN KEITH CLUTE PHYISCAL THERAPIST (OWNER)
(206) 542-1986
Entity
Organization

Contact information

Practice address
1207 N 200TH ST, 103, SHORELINE, WA 98133-3213
(206) 542-1986
(206) 542-1144
Mailing address
1207 N 200TH ST, 103, SHORELINE, WA 98133-3213
(206) 542-1986
(206) 542-1144

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00003503
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0148810
LABOR AND INDUSTRIES
WA
01
242772700
ACS
WA
01
7061617
SOCIAL & HEALTH SERVICES
WA
Enumeration date
11/16/2006
Last updated
08/19/2016
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