| NPI | 1982017463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE SPARKS Owner 509-340-3303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WA MA60471245) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |