| NPI | 1427113174 |
|---|---|
| Doing Business As | IRG AT EVERETT SPORTS |
| Entity Type | Organization |
| Authorized Contact | MICHAEL SHANNON O'KELLEY President 425-337-9556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-08-22 |