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General NPI Number Information
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NPI Number | 1154378750
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL MEDICINE ASSOCIATES PS
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 08/13/2010
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Provider Practice Location Address
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Address Line | 323 E SECOND AVENUE SUITE 102
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City | SPOKANE
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State | WA
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Zip | 99202
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Country | US
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Telephone | 509-455-5555
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Fax | 509-455-4114
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Provider Business Mailing Address
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Address Line | 323 E SECOND AVENUE SUITE 102
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City | SPOKANE
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State | WA
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Zip | 99202
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Country | US
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Telephone | 509-455-5555
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Fax | 509-455-4114
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | PAULA A LANTSBERGER
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Credential | MD MPH FACOEM
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Telephone | 509-455-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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