| NPI | 1720040397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADY W CORSE Athletic Trainer 360-514-2048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OR AT-AT-707950) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2020-08-22 |