| NPI | 1114296670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDR IVANOVICH CHATILO Provider 206-366-5379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD00044546) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2011-12-29 |