| NPI | 1326090721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH MAYBERRY Clinical Staff Manager 452-451-2272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD00033845) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-08-22 |