Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1679155196 |
---|---|
Provider Name | James George Anastassiades |
First Address | Spokane, WA 99208-6394 |
Second Address | Spokane, WA 99208-6394 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2021 |
Last Update Date | 23/04/2021 |