| NPI | 1720307382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY L. FAVERO Owner 509-962-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD00047820) |
| 225700000X Massage Therapist | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA MD00047820) | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2012-03-28 |