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5522 Freeland Ave, Freeland, WA 98249-9734 | |
(425) 327-8056 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 5522 Freeland Ave, Freeland, Washington |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619754926 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Michael A Lodell |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1518330869 PECOS PAC ID: 8022318633 Enrollment ID: I20151204000301 |
Mailing Address | Practice Location Address |
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5522 Freeland Ave, Freeland, WA 98249-9734 Ph: (360) 331-0337 | 5522 Freeland Ave, Freeland, WA 98249-9734 Ph: (425) 327-8056 |