Individual
MRS. JENNIFER LEE WOLBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPO
Contact information
Practice address
317 WELLSIAN WAY, RICHLAND, WA 99352-4116
(095) 943-8561
(509) 943-1037
Mailing address
317 WELLSIAN WAY, RICHLAND, WA 99352-4116
(509) 943-8561
(509) 943-1037
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114479573
—
WA
Enumeration date
11/01/2016
Last updated
05/05/2020
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