Provider Demographics
NPI:1437779899
Name:WEST PHYSICAL THERAPY. INC
Entity type:Organization
Organization Name:WEST PHYSICAL THERAPY. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DHA
Authorized Official - Phone:912-658-1234
Mailing Address - Street 1:16 10TH ST
Mailing Address - Street 2:
Mailing Address - City:TYBEE ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31328-8807
Mailing Address - Country:US
Mailing Address - Phone:912-658-1234
Mailing Address - Fax:912-472-4352
Practice Address - Street 1:16 10TH ST
Practice Address - Street 2:
Practice Address - City:TYBEE ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31328-8807
Practice Address - Country:US
Practice Address - Phone:912-663-7264
Practice Address - Fax:912-472-4352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-25
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty