Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Performance Sports and Spine Physical Therapy Ps

Organization Physical Therapist · NPI 1093957292

Performance Sports and Spine Physical Therapy Ps provides Physical Therapist services 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
Show map & directions

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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