Jody Welcker Provine, PTA
NPI #1841669272 in North Bend, Washington
Provider Information
- NPI Number
- 1841669272
- Entity Type
- Individual
- Name
- Jody Welcker Provine, PTA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Skilled Nursing Facility
- Credential
- PTA
- Enumeration Date
- Sep 16, 2015
- Last Updated
- Sep 16, 2015
Practice Location
- Address
- 219 CEDAR AVE S
- City
- North Bend
- State
- Washington
- ZIP Code
- 98045-8262
- Phone
- (425) 888-2129
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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