GLENN GORDON WILSON

SPOKANE, WA
NPI1417471426
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224P00000X Prosthetist
(Licence: WA  PS60602304)
Enumeration Date2017-08-01
Last Update Date2017-08-01
Business Address
Mr. GLENN GORDON WILSON CP(c)CO,BOCP
514 S WASHINGTON ST
SPOKANE, WA 99204-2620
Phone number: 509-624-3314
Mailing Address
Mr. GLENN GORDON WILSON CP(c)CO,BOCP
4214 S SULLIVAN RD
VERADALE, WA 99037-9187
Phone number: 406-750-0123
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