| NPI | 1174791974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH J RITTER Owner 253-272-3149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: WA 05834) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2010-11-12 |