| NPI | 1831561497 |
|---|---|
| Former Name | NICHOLAS ADAM RUNTE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60494601) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2023-04-10 |