Individual
BRIAN LEE HANNIBAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
623 W GARLAND AVE, SPOKANE, WA 99205-2956
(509) 209-9488
Mailing address
32832 N 14TH AVE, SPIRIT LAKE, ID 83869-7718
(208) 640-9401
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A161663014
WA
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/27/2021
Last updated
01/12/2026
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