Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT00008107 | WA |
NPI | 1013112705 |
---|---|
Provider Name | Kimberly Zavack |
First Address | Bremerton, WA 98311-8209 |
Second Address | Bremerton, WA 98310-3313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 08/07/2007 |