| NPI | 1487148680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN DAVID KIELY Administrator 509-885-2844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 204D00000X Neuromusculoskeletal Medicine & OMM | |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |