JON MARK WAHLSTROM

PUYALLUP, WA
NPI1033583182
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WA  P160038469)
Enumeration Date2015-11-29
Last Update Date2015-11-29
Business Address
MR. JON MARK WAHLSTROM PTA
7604 145TH STREET CT E
PUYALLUP, WA 98375-7095
Phone number: 253-278-2291
Mailing Address
MR. JON MARK WAHLSTROM PTA
7604 145TH STREET CT E
PUYALLUP, WA 98375-7095
Phone number: 253-278-2291