# SPOKANE SPORTS AND SPINE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467527853
- **Authorized official:** JOHN LONG D.O. (PHYSICIAN)
- **Authorized official phone:** (509) 242-6005

## Contact information

- **Practice address:** 765 E HOLLAND AVE, SUITE 1, SPOKANE, WA 99218-1280
- **Practice address phone:** (509) 242-6005
- **Mailing address:** 765 E HOLLAND AVE, SUITE 1, SPOKANE, WA 99218-1280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 12/11/2007