| NPI | 1013200492 |
|---|---|
| Doing Business As | KINETIC SPORTS REHAB |
| Entity Type | Organization |
| Authorized Contact | MICHAEL D BOURBONNAIS Owner 206-547-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: CH00034592) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00003244) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |