| NPI | 1043578776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY T BALENTINE Provider/Owner 253-588-7911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WA MD60036029) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |