Organization
NW INTERVENTIONAL MEDICINE AND ORTHOPEDIC REHAB PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE BACK DC (OWNER/MANAGER)
(360) 253-6883
Entity
Organization
Contact information
Practice address
11802 NE 65TH ST., VANCOUVER, WA 98662
(360) 253-6883
(360) 892-7040
Mailing address
11802 NE 65TH ST., VANCOUVER, WA 98662
(360) 253-6883
(360) 892-7040
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
04/18/2016
Last updated
04/18/2016
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