GEORGE JUPITER

RENTON, WA
NPI1811107345
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: LA  A6637)
Enumeration Date2007-05-23
Last Update Date2007-07-08
Business Address
-- GEORGE JUPITER PTA
2320 TALBOT CREST DR S
RENTON, WA 98055-4209
Phone number: 337-319-4644
Mailing Address
-- GEORGE JUPITER PTA
2320 TALBOT CREST DR S
RENTON, WA 98055-4209
Phone number: