| NPI | 1861023004 |
|---|---|
| Doing Business As | PRIME SPORTS INSTITUTE |
| Entity Type | Organization |
| Authorized Contact | KERRY GUSTAFSON Owner 360-922-3120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2020-01-27 |