| NPI | 1154747947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT JAMES THIELGES Owner/Provider 509-591-9454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PO60436994) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2023-07-31 |