Provider Demographics
NPI:1154764256
Name:MOBILIZE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:MOBILIZE PHYSICAL THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELCY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:206-402-5483
Mailing Address - Street 1:3515 NE 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5640
Mailing Address - Country:US
Mailing Address - Phone:206-402-5483
Mailing Address - Fax:206-299-0962
Practice Address - Street 1:3515 NE 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5640
Practice Address - Country:US
Practice Address - Phone:206-402-5483
Practice Address - Fax:206-299-0962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty