Organization
SPOKANE SPORTS AND SPINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LONG D.O. (PHYSICIAN)
(509) 242-6005
Entity
Organization
Contact information
Practice address
765 E HOLLAND AVE, SUITE 1, SPOKANE, WA 99218-1280
(509) 242-6005
Mailing address
765 E HOLLAND AVE, SUITE 1, SPOKANE, WA 99218-1280
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD1750
RAILROAD MEDICARE
WA
Enumeration date
11/21/2006
Last updated
12/11/2007
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