Organization
REP FITNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYSON J VAN DAM (OWNER)
(360) 240-9231
Entity
Organization
Contact information
Practice address
632 ERIN PARK RD, SUITE A, OAK HARBOR, WA 98277-2705
(360) 240-9231
Mailing address
632 ERIN PARK RD, SUITE A, OAK HARBOR, WA 98277-2705
(360) 240-9231
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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