| NPI | 1003982745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT W WAHLBERG PT Owner 509-758-8510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00005041) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT396) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2009-12-17 |