NPI | 1568544757 |
---|---|
Entity Type | Organization |
Authorized Contact | EDDY D. DEBOO Owner 360-715-8686 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 602346794) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: WA 602346794) |
Enumeration Date | 2006-10-19 |
Last Update Date | 2010-07-28 |