Organization
PNEUBACK SPORTS & THERAPY INSTITUTE NORTHWEST LLC
Active
Parent organization
PNEUBACK SPORT & THERAPY INSTITUTE NORTHWEST
Other names
Revita Rehab
Organization subpart
Yes
Provider details
NPI number
Legal business name
PNEUBACK SPORT & THERAPY INSTITUTE NORTHWEST
Authorized official
BETHANY BROWN (CLINIC ADMINISTRATOR)
(509) 343-3150
Entity
Organization
Contact information
Practice address
1421 N MULLAN RD, SUITE B, SPOKANE VALLEY, WA 99206-4051
(509) 343-3150
(866) 332-9903
Mailing address
1421 N MULLAN RD, SUITE B, SPOKANE VALLEY, WA 99206-4051
(509) 343-3150
(866) 332-9903
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740264142
NPI
WA
Enumeration date
12/01/2009
Last updated
03/29/2012
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