Individual
MR. MACARIO AT CONVENTO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
PUGET SOUND HEALTH CARE SYSTEM AMERICAN LAKE DIV., 9600 VET. DR. SW, TACOMA, WA 98493-0001
(253) 583-1810
Mailing address
24007 84TH AVE E, GRAHAM, WA 98338-9392
(253) 583-1810
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/24/2006
Last updated
07/08/2007
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