Organization
JAVAMAN PS
Active
Other names
Fyzical Therapy & Balance Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC DAVID SHORT-MILLER PT (OWNER VICE PRESIDENT)
(360) 733-4008
Entity
Organization
Contact information
Practice address
2075 BARKLEY BLVD, STE 200, BELLINGHAM, WA 98226-6696
(360) 733-4008
(360) 733-4064
Mailing address
2075 BARKLEY BLVD, STE 200, BELLINGHAM, WA 98226-6696
(360) 733-4008
(360) 733-4064
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
601822178
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0118842
LABOR AND INDUSTRY
WA
05
—
7087836
—
WA
Enumeration date
04/18/2006
Last updated
03/15/2018
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