Individual
JUMAN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4800 COLLEGE ST SE, LACEY, WA 98503-4389
(360) 486-2900
Mailing address
4800 COLLEGE ST SE, LACEY, WA 98503-4389
(360) 486-2900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61283328
WA
Other
Enumeration date
06/03/2022
Last updated
06/03/2022
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