BRENT M DEBOLT

VANCOUVER, WA
NPI1235434341
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: WA  LP60203433)
Enumeration Date2011-01-20
Last Update Date2011-01-20
Business Address
-- BRENT M DEBOLT LPN
2314 E 13TH ST
VANCOUVER, WA 98661-4122
Phone number: 503-709-7122
Mailing Address
-- BRENT M DEBOLT LPN
2314 E 13TH ST
VANCOUVER, WA 98661-4122
Phone number: 503-709-7122
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