Provider Demographics
NPI:1851946685
Name:INTEGRAL FOUNDATIONS PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:INTEGRAL FOUNDATIONS PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:985-320-1057
Mailing Address - Street 1:18208 66TH AVE NE STE 201
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-7949
Mailing Address - Country:US
Mailing Address - Phone:206-636-1133
Mailing Address - Fax:
Practice Address - Street 1:18208 66TH AVE NE STE 201
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-7949
Practice Address - Country:US
Practice Address - Phone:206-636-1133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty