| NPI | 1528034030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHUCK STILLWAGGON Practice Administrator 509-834-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA 602044113) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2023-01-26 |