Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DENR.DN.60073340 | WA |
NPI | 1629212758 |
---|---|
Provider Name | Mr. Joseph Perrin Osborn |
First Address | Spokane Valley, WA 99206-5120 |
Second Address | Spokane Valley, WA 99206-5120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2009 |
Last Update Date | 20/04/2009 |