Individual
JISELLE S URBANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1133 N GRAPE DR, B204, MOSES LAKE, WA 98837-4052
(509) 750-1549
Mailing address
1133 N GRAPE DR, B204, MOSES LAKE, WA 98837-4047
(509) 750-1549
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
7535059-2401
UT
225100000X
Physical Therapist
Primary
PT60124596
WA
Other
Enumeration date
12/21/2009
Last updated
09/27/2012
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