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Individual

ELENA SUZANNE WACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
9514 GRAVELLY LAKE DR SW, LAKEWOOD, WA 98499-1514
(253) 983-9395
Mailing address
9315 GRAVELLY LAKE DR SW, SUITE 306, LAKEWOOD, WA 98499-1574
(253) 581-5200
(253) 581-5203

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60421494
WA

Other

Enumeration date
02/19/2014
Last updated
02/19/2014
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