Individual
ANNA VITALEVNA FOMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5210 N HARVARD RD, OTIS ORCHARDS, WA 99027-9282
(509) 475-1551
Mailing address
5210 N HARVARD RD, OTIS ORCHARDS, WA 99027-9282
(509) 475-1551
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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