Organization
ASCENT PHYSICAL THERAPY SERVICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY LARSON MAPT (OWNER)
(509) 826-9533
Entity
Organization
Contact information
Practice address
11 N. MAIN ST., OMAK, WA 98841-1122
(509) 826-9533
(509) 826-1152
Mailing address
PO BOX 1122, OMAK, WA 98841-1122
(509) 826-2859
(509) 826-1152
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT00006179
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7081896
—
WA
01
—
GAB00169
MEDICARE OLD PIN
WA
Enumeration date
08/02/2010
Last updated
09/26/2016
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