| NPI | 1013427004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AILEEN WEDVIK Owner 253-581-3075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-04 |