Individual
JUSTIN BURGERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 N EVERGREEN RD # 102, SPOKANE VALLEY, WA 99216-5083
(509) 924-5665
Mailing address
6705 N RYLEY LN, OTIS ORCHARDS, WA 99027-8226
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD60672832
WA
Other
Enumeration date
08/26/2016
Last updated
08/26/2016
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