Organization
GRAVELLY LAKE PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE ANN BURKHART MPT (PRESIDENT)
(253) 588-2880
Entity
Organization
Contact information
Practice address
3130 SYLVAN DR W, UNIVERSITY PLACE, WA 98466-2514
(253) 588-2880
Mailing address
PO BOX 65368, UNIVERSITY PLACE, WA 98464-1368
(253) 588-2880
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
WA
Other
Enumeration date
05/22/2007
Last updated
09/28/2007
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