| NPI | 1952893703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG BROCKBANK President 509-868-5865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: UT 356685-0501) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-06-06 |