Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1104034669 |
---|---|
Provider Name | Terence Lee Andres |
First Address | Spokane, WA 99201-3034 |
Second Address | Spokane, WA 99201-3034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |