Provider Demographics
NPI:1184742496
Name:SYMMETRY PHYSICAL THERAPY & SCOLIOSIS CARE
Entity type:Organization
Organization Name:SYMMETRY PHYSICAL THERAPY & SCOLIOSIS CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAYLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:425-330-1228
Mailing Address - Street 1:13024 BEVERLY PARK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-5857
Mailing Address - Country:US
Mailing Address - Phone:425-353-8797
Mailing Address - Fax:425-353-8765
Practice Address - Street 1:13024 BEVERLY PARK RD
Practice Address - Street 2:STE 102
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-5857
Practice Address - Country:US
Practice Address - Phone:425-353-8797
Practice Address - Fax:425-353-8765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty