| NPI | 1023301868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAWN JENNIE COUSSENS Physical Therapist, Owner 206-632-0163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: WA 602928536) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2022-08-30 |