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Individual

DR. MICHAEL JUSTIN SIROTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
902 ENGH RD, OMAK, WA 98841-9473
(509) 846-3930
(509) 288-4269
Mailing address
PO BOX 10772, SPOKANE, WA 99209-0772
(509) 846-3930
(509) 288-4269

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
103000
ID
152W00000X
Optometrist
Primary
WA 3806
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1508979493
WA
Enumeration date
08/16/2006
Last updated
02/02/2016
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