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1376536243
BRIAN A THACKER
PUYALLUP, WA
NPI
1376536243
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WA PT00007968)
Enumeration Date
2005-08-25
Last Update Date
2013-05-21
Business Address
-- BRIAN A THACKER DPT, OCS, SCS, COMT
17520 MERIDIAN E STE F
PUYALLUP, WA 98375-6265
Phone number: 253-864-7595
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Mailing Address
-- BRIAN A THACKER DPT, OCS, SCS, COMT
PO BOX 24283
SEATTLE, WA 98124-0283
Phone number: 253-581-5200
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