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General NPI Number Information
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NPI Number | 1093161226
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Entity Type | Organization
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Legal Business Name | BRENT FINNIGAN LMP
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Dates
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Enumeration Date | 05/06/2016
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Last Update Date | 05/06/2016
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Provider Practice Location Address
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Address Line | 4537 YAKIMA AVE
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City | TACOMA
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State | WA
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Zip | 98418
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Country | US
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Telephone | 253-475-3334
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Fax | 253-475-0875
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Provider Business Mailing Address
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Address Line | 4537 YAKIMA AVE
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City | TACOMA
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State | WA
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Zip | 98418-4929
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Country | US
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Telephone | 253-475-3334
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Fax | 253-475-0875
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRENT FINNIGAN
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Credential | LMT
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Telephone | 253-475-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | MA00005855
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License Number State | WA
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