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Individual

WALTER WOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA, PES, CES

Contact information

Practice address
1132 E POLSTON AVE, POST FALLS, ID 83854-6045
(208) 777-7800
Mailing address
5111 S REGAL ST APT 3, SPOKANE, WA 99223-9102
(509) 590-8485

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
P160049952
WA
225200000X
Physical Therapy Assistant
Primary
PTA-2416
ID
2255A2300X
Athletic Trainer

Other

Enumeration date
07/27/2006
Last updated
08/27/2014
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