Individual
MR. JOHN RICHARD ELVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LD
Contact information
Practice address
292 CHEHALIS VALLEY RD, CHEHALIS, WA 98532
(360) 259-9157
Mailing address
292 CHEHALIS VALLEY RD, CHEHALIS, WA 98532
(360) 259-9157
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000197
WA
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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