Provider Demographics
NPI:1801421086
Name:GROOVIN' PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:GROOVIN' PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:OVERBAY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:206-240-0419
Mailing Address - Street 1:10734 17TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6506
Mailing Address - Country:US
Mailing Address - Phone:206-240-0419
Mailing Address - Fax:
Practice Address - Street 1:10734 17TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6506
Practice Address - Country:US
Practice Address - Phone:206-240-0419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-07
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty