Individual
COLIN IRVIN HOLGANZA ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
316 1ST AVE N, ILWACO, WA 98624-9140
(360) 642-6328
Mailing address
PO BOX 552, ILWACO, WA 98624-0552
(253) 386-0758
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61337277
WA
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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