| NPI | 1528391810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BLISS Owner 509-624-9112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: WA MD00042250) |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2009-09-17 |