Individual
LEANDRO MODENESE BASTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT DPT
Contact information
Practice address
12403 E 1ST AVE, SPOKANE VALLEY, WA 99216-0702
(509) 370-7597
Mailing address
4915 W ROSEWOOD AVE, SPOKANE, WA 99208-3740
(562) 212-8477
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
296037
CA
Other
Enumeration date
12/17/2018
Last updated
03/27/2025
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