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1356804314
ALEXIS GHOLSTON
CHENEY, WA
NPI
1356804314
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WA A160913495)
Enumeration Date
2019-04-08
Last Update Date
2019-04-08
Business Address
ALEXIS GHOLSTON LAT, ATC
207 PHYSICAL EDUCATION BUILDING
CHENEY, WA 99004-2476
Phone number: 509-598-0978
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Mailing Address
ALEXIS GHOLSTON LAT, ATC
201 BETZ RD APT 221
CHENEY, WA 99004-9182
Phone number: 509-949-5305
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