Individual
KELLY J PRATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
321 BURDIN BLVD, GRAND COULEE PHYSICAL THERAPY, GRAND COULEE, WA 99133
(509) 633-3260
(509) 633-3212
Mailing address
10668 HIGHWAY 2 NE, COULEE CITY, WA 99115
(509) 632-5335
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00003785
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
185740
WA DEPT OF LABOR & INDUST
WA
Enumeration date
01/23/2007
Last updated
07/08/2007
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