Provider Demographics
NPI:1386624997
Name:ANACORTES PHYSICAL THERAPY, INC., P.S.
Entity type:Organization
Organization Name:ANACORTES PHYSICAL THERAPY, INC., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/P.T.
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:E
Authorized Official - Last Name:FRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-299-2781
Mailing Address - Street 1:3001 R AVE
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-4602
Mailing Address - Country:US
Mailing Address - Phone:360-299-2781
Mailing Address - Fax:360-299-3038
Practice Address - Street 1:3001 R AVE
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-4602
Practice Address - Country:US
Practice Address - Phone:360-299-2781
Practice Address - Fax:360-299-3038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7096266Medicaid
WA0158139OtherLABOR & INDUSTRIES
WA0158139OtherLABOR & INDUSTRIES