| NPI | 1871173690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN LEONE Business Manager 253-471-1287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2021-06-03 |