Back to Form Structural Strength and Massage
NPI #1003332255 in Seattle, Washington
Provider Information
- NPI Number
- 1003332255
- Entity Type
- Organization
- Organization Name
- Back to Form Structural Strength and Massage
- Primary Specialty
- Massage Therapist
- Enumeration Date
- Aug 18, 2017
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 509 OLIVE WAY STE 851
- City
- Seattle
- State
- Washington
- ZIP Code
- 98101-1769
- Phone
- (206) 383-3186
Authorized Official
- Name
- MR. KEVIN LEE VANDENBOSCH, LMP
- Title
- OWNER/LMP
- Phone
- (206) 383-3186
Specialties & Taxonomy Codes
| Specialty |
|---|
| Massage Therapist |
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