Individual
ALEXIS GHOLSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
207 PHYSICAL EDUCATION BUILDING, CHENEY, WA 99004-2476
(509) 598-0978
Mailing address
201 BETZ RD APT 221, CHENEY, WA 99004-9182
(509) 949-5305
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160913495
WA
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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