Individual
GEORGE JUPITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2320 TALBOT CREST DR S, RENTON, WA 98055-4209
(337) 319-4644
Mailing address
2320 TALBOT CREST DR S, RENTON, WA 98055-4209
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A6637
LA
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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