Individual
EWING FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
126 15TH ST SE, PUYALLUP, WA 98372-3409
(253) 350-8830
Mailing address
126 15TH ST SE, PUYALLUP, WA 98372-3409
(253) 350-8830
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1 60039659
WA
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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