Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Performance Sports and Spine Physical Therapy Ps

Organization Physical Therapist · NPI 1093957292

Performance Sports and Spine Physical Therapy Ps is a Physical Therapist in Bonney Lake, Washington. Registered with an NPI since 2009.

In the registry since
2009

Practice location Address checks out

21525 Hwy 410 E Ste B
Bonney Lake, WA 98391-4101
Phone: (253) 826-8520
Fax: (253) 826-8522
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1093957292
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bobby Ismail — President · (209) 353-1988
NPI enumeratedApril 2, 2009
Last updated in NPPESDecember 6, 2023
Certification dateDecember 6, 2023
Mailing address21525 Hwy 410 E, Suite B, Bonney Lake, WA 98391-4101

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