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Individual

BRIAN E KOONTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
219 NE MOE ST, POULSBO, WA 98370-7347
(360) 860-0150
Mailing address
PO BOX 529, INDIANOLA, WA 98342-0529
(360) 860-0150

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00006143
WA

Other

Enumeration date
09/10/2007
Last updated
09/10/2007
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