Van Wagner Ventures LLC

NPI #1073614525 in Kent, Washington

Provider Information

NPI Number: 1073614525
Entity Type: Organization
Organization Name: Van Wagner Ventures LLC
Primary Specialty: Physical Therapist
Enumeration Date: Sep 26, 2006
Last Updated: Oct 8, 2007

Practice Location

Address: 22710 126TH PL SE
City: Kent
State: Washington
ZIP Code: 98031-3666
Phone: (206) 595-5085

Authorized Official

Name: PATRICIA SUE VANWAGNER
Title: OWNER
Phone: (206) 595-5085

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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