| NPI | 1730582693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYAN N PROUSE Owner 360-731-1243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WA 00007497) |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2014-10-06 |