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General NPI Number Information
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NPI Number | 1700225653
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Entity Type | Individual
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Provider Name | ERIC THOMAS GEORGE LCO
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Gender | Male
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Dates
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Enumeration Date | 06/24/2013
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Last Update Date | 06/24/2013
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Provider Practice Location Address
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Address Line | 9611 MICKELBERRY RD NW STE A
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City | SILVERDALE
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State | WA
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Zip | 98383-8300
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Country | US
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Telephone | 360-698-2229
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Fax | 360-698-0122
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Provider Business Mailing Address
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Address Line | PO BOX 1546
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City | GRAHAM
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State | WA
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Zip | 98338-1546
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Country | US
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Telephone | 360-447-0770
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Fax | 253-875-7768
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | OI60351084
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License Number State | WA
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