| NPI | 1811503691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY REISIG STAUBER Physical Therapist 360-303-8353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |