| NPI | 1417093048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKSIE K LARSON Owner President 509-758-5647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00008466) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT1411) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2014-09-03 |