Most Relevant Information
Provider Data
| NPI Number: | 1003020520 |
| Provider Name: | JESSE RYAN POOLER M.P.T. |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT0008913 |
Most Important Dates
| Enumeration Date: | 05/10/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
621 S PINE ST
TACOMA
WA
984052761
Practice Location Phone/Fax
| Phone: | 2538358091 |
| Fax: |
Provider Mailing Location
621 S PINE ST
TACOMA
WA
984052761
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |