| NPI | 1861918518 |
|---|---|
| Doing Business As | PRO SPORTS CLUB |
| Entity Type | Organization |
| Authorized Contact | DEBBIE BECKER Sr Director Of Accounting 425-869-4746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 600541508) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WA 600541508) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2022-07-21 |