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1003163866
PETER KELLEY JANICKI
PUYALLUP, WA
NPI
1003163866
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WA PT60282435)
Enumeration Date
2012-08-11
Last Update Date
2012-08-11
Business Address
-- PETER KELLEY JANICKI PT
3912 10TH ST SE SUITE 101
PUYALLUP, WA 98374-2188
Phone number: 253-848-4700
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Mailing Address
-- PETER KELLEY JANICKI PT
PO BOX 2170
SUMNER, WA 98390-0480
Phone number: 253-840-2313
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