| NPI | 1760562995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH JEAN KRISTOVICH Owner 253-396-9001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00005372) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2018-03-28 |