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Individual

LANE MATTHEW NUSSBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
2710 E 57TH AVE, SPOKANE, WA 99223-6678
(509) 252-2354
(509) 252-2357
Mailing address
2710 E 57TH AVE, SPOKANE, WA 99223-6678
(509) 252-2354
(509) 252-2357

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009353
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
207659
L&I PROVIDER NUMBER
WA
Enumeration date
07/06/2006
Last updated
12/07/2022
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