Organization
WOODLAND CREEK PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT O. ENSIGN MPT, JSCC (OWNER)
(360) 412-1367
Entity
Organization
Contact information
Practice address
5205 CORPORATE CENTER CT SE, SUITE C, LACEY, WA 98503-5901
(360) 412-1367
(360) 412-1391
Mailing address
5205 CORPORATE CENTER CT SE, SUITE C, LACEY, WA 98503-5901
(360) 412-1368
(360) 412-1391
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
602 027 552
WA
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7102437
—
WA
Enumeration date
11/01/2006
Last updated
05/19/2014
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