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Individual

MRS. NOVA DAWN PRATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
525 E COTTONWOOD, REARDAN, WA 99029
(509) 796-2860
(509) 796-2860
Mailing address
PO BOX 343, REARDAN, WA 99029-0343
(509) 796-2860
(509) 796-2860

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60263446
WA

Other

Enumeration date
02/03/2012
Last updated
02/03/2012
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