| Valley Physical Therapy Ps | |
| 
					433 Elm Street, Clarkston, WA 99403-2650  | |
| (509) 758-5647 | |
| (509) 758-5648 | 
| Full Name | Valley Physical Therapy Ps | 
|---|---|
| Type | Facility | 
| Speciality | Physical Therapist | 
| Location | 433 Elm Street, Clarkston, Washington | 
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1417093048 | NPI | - | NPPES | 
| 805941300 | Medicaid | ID | |
| 8379778 | Medicaid | WA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 225100000X | Physical Therapist | PT1411 (Idaho) | Secondary | 
| 225100000X | Physical Therapist | PT00008466 (Washington) | Primary | 
| Provider Name | Brooksie K Larson | 
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice | 
| Provider Identifiers | NPI Number: 1033395322 PECOS PAC ID: 4486645132 Enrollment ID: I20040520001269  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Valley Physical Therapy Ps 433 Elm Street, Clarkston, WA 99403-2650 Ph: (509) 758-5647  | Valley Physical Therapy Ps 433 Elm Street, Clarkston, WA 99403-2650 Ph: (509) 758-5647  | 
Twin Rivers Physical Therapy, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 725 6th St, Ste 101, Clarkston, WA 99403 Phone: 509-758-8510 Fax: 509-751-9149  | |
Knelsen Twin Rivers Physical Therapy Physical Therapist Medicare: Medicare Enrolled Practice Location: 725 6th St, Clarkston, WA 99403 Phone: 508-769-0004  | |
Thomas Clemens, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 725 6th St, Clarkston, WA 99403 Phone: --  | |
Ms. Brooksie K Larson,  Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 433 Elm St, Clarkston, WA 99403 Phone: 509-758-5647 Fax: 509-758-5648  | |
Mr. Donald Daryl Fredericksen, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1727 Ridgeview Dr, Clarkston, WA 99403 Phone: 509-780-2111  | |
Mr. Brent Wesley Wahlberg Jr., RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 725 6th St Ste 101, Clarkston, WA 99403 Phone: 509-758-8510 Fax: 509-751-9149  |