Organization Name: | OLYMPIC SPORTS AND SPINE REHABILITATION, P.S. |
NPI Number: | 1144685306 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRIAN THACKER (VICE PRESIDENT) |
Mailing Address: | 17520 Meridian E Suite F Puyallup |
State: | WA US |
Postal Code: | 983756265 |
Phone Number: | 2538647595 |
Fax Number: | 2538640457 |
NPI Enumeration Date: | 12/15/2015 |
NPI Last Update Date: | 12/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |