Individual
TERESA SANDOVAL GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2316 EASTGATE ST, #110, WALLA WALLA, WA 99362-2554
(509) 527-1156
(509) 522-4933
Mailing address
2316 EASTGATE ST, #110, WALLA WALLA, WA 99362-2554
(509) 527-1156
(509) 522-4933
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60476578
WA
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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