Individual
ANN VICTORIA BONACUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1328 S SOUTHEAST BLVD, SPOKANE, WA 99202-2570
(509) 536-1620
Mailing address
1328 S SOUTHEAST BLVD, SPOKANE, WA 99202-2570
(509) 536-1620
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
60199590
WA
Other
Enumeration date
12/21/2010
Last updated
12/21/2010
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