| NPI | 1831647627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINT BURGENER Owner 509-527-1156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: WA MA60656571) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2016-09-21 |