| NPI | 1659551885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT L FRERICHS Provider/Owner 253-588-7911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WV MD00024815) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2007-11-05 |