Proactive Sportsmed in Lacey - Orthopedic
Proactive Sportsmed - NPI 1861612335
Proactive Sportsmed is a Orthopedic in Lacey, Washington. Proactive Sportsmed practices all healthcare services and medical treatments related to Orthopedic. The NPI Number for Proactive Sportsmed is 1861612335. The last update date is 2020-08-22.
Proactive Sportsmed's current location address is 4200 6th Ave Se Ste 203, Lacey, Washington. You can contact this provider via phone number 3604554448 and fax number 3604559833. The mailing address for Proactive Sportsmed is 4200 6th Ave Se Ste 203, Lacey, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Proactive Sportsmed |
|---|---|
| Address | 4200 6th Ave Se Ste 203, Lacey, Washington |
| Phone Number | 3604554448 |
| Fax Number | 3604559833 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CLINIC DIR |
|---|---|
| Authorized Official Name | Gildner A Vince |
| Credentials | PT, ATC, C |
| Telephone Number | 3604554448 |
NPI Number Detail
| NPI Number | 1861612335 |
|---|---|
| Provider Enumeration Date | 2007-04-26 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 4200 6th Ave Se Ste 203 |
|---|---|
| City | Lacey |
| State | Washington (WA) |
| Post Code | 985031042 |
| Phone Number | 3604554448 |
| Fax Number | 3604559833 |
Provider's Primary Taxonomy Detail
| Speciality | Orthopedic |
|---|---|
| Taxonomy | 2251X0800X |
|
Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pat |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7112923 | WA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Proactive Sportsmed by the Centers for Medicare & Medicaid Services?
The Proactive Sportsmed has been assigned the NPI (National Provider Identifier) 1861612335 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete address where Proactive Sportsmed is physically located?
The Proactive Sportsmed is situated at the following address: 4200 6Th Ave Se Ste 203, Lacey, WA 985031042.
What is Proactive Sportsmed's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Proactive Sportsmed is Orthopedic, and the corresponding taxonomy classification code for this specialized field is 2251X0800X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1861612335 to Proactive Sportsmed?
The Centers for Medicare & Medicaid Services originally issued the 1861612335 to Proactive Sportsmed on 2007-04-26.
When was the information regarding Proactive Sportsmed most recently updated?
The details pertaining to the Proactive Sportsmed, including its address, specialty, and other relevant information, were last refreshed on 2020-08-22.
NPI Number: 1457354839
Address: P.o. Box 1252, Spartanburg, SC