| NPI | 1508352881 |
|---|---|
| Doing Business As | PRO SPORTS CLUB |
| Entity Type | Organization |
| Authorized Contact | MELISSA BURGESS Medical Billing & Credentialing 425-895-6575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WA 600541508) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |