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Organization

PERSONAL PHYSICAL THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIUSZ STAWOWSKI PT (OFFICER)
(509) 946-9007
Entity
Organization

Contact information

Practice address
702 JADWIN AVE STE A, RICHLAND, WA 99352-4256
(509) 946-9007
(509) 946-9755
Mailing address
702 JADWIN AVE STE A, RICHLAND, WA 99352-4256
(509) 946-9007
(509) 946-9755

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT00008664
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0195507
L&I
WA
05
7136021
WA
Enumeration date
11/09/2007
Last updated
10/15/2012
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