Organization
BONNIE PETERSON
Active
Other names
On Broadway
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE PETERSON (OWNER)
(509) 413-2790
Entity
Organization
Contact information
Practice address
3120 S GRAND BLVD UNIT 8473, SPOKANE, WA 99203-2681
(509) 315-5561
(509) 315-8354
Mailing address
915 W BROADWAY AVE, SPOKANE, WA 99201-2119
(509) 413-2790
(509) 315-8354
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60112430
WA
Other
Enumeration date
02/06/2013
Last updated
02/06/2013
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