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PHYSICAL THERAPY EMPOWERED, PLLC

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Company Details

Legal Name: PHYSICAL THERAPY EMPOWERED, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: October 11th 2019
Expiration date: 31 Oct 2025
UBI Number: 604 528 614
ZIP code: 98501
City: Olympia
County: THURSTON
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 128 D ST SW, TUMWATER, WA, 98501-4064, UNITED STATES

Contact Details

E-Mail: BENNETT@PTEMPOWERED.COM
Phone Number: +1 360-349-8606

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
BRANDON BENNETT Registered Agent 15621 VAIL CUT OFF RD SE, RAINIER, WA, 98576, UNITED STATES

Key Officers & Management

Name Role Address
SARAH BENNETT Executor 7605 38TH CT SE, LACEY, WA, 98503-4804, UNITED STATES
BRANDON BENNETT Governing Person -

National Provider Identifier

NPI Number:
1912538505
Certification Date:
2023-06-28

Authorized Person:

Name:
BRANDON BENNETT
Role:
PHYSICAL THERAPIST
Phone:

Taxonomy:

Selected Taxonomy:
261QP2000X - Physical Therapy Clinic/Center
Is Primary:
No
Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

History

Type Old value New value Date of change
Name change EMPOWER PHYSICAL THERAPY PLLC PHYSICAL THERAPY EMPOWERED, PLLC 2020-01-27
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