Individual
MISS JOLENE M WIXOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1103 E GARLAND AVE, SPOKANE, WA 99207-3035
(509) 280-6615
Mailing address
1103 E GARLAND AVE, SPOKANE, WA 99207-3035
(509) 280-6615
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00019944
WA
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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