| 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 |