Shane B Carson D.O.

NPI 1710917299 - Pediatrics - 208000000X

NPI Details
NPI 1710917299
Gender Male
Enumeration Date 07/03/2006
Last Updated 07/23/2015
Entity Type Individual
Active Over 11 years ago
Practice Location
STE 117
SPOKANE WA, 99207-1240, US
Phone (509) 747-3081
Business Location
PO BOX 421
LIBERTY LAKE WA, 99019-0421, US
Phone (509) 747-3081
Fax (509) 455-8462
Taxonomy Code 208000000X
License State Washington
License Number OP00002101
Remove 1710917299 NPI Number

According to our database, Shane B Carson D.O. NPI is 1710917299, taxonomy code is 208000000X and license number is OP00002101, license state is located at Washington. Shane B Carson D.O. physically located at 235 E Rowan Ave, Spokane WA, 99207-1240. NPI Number Shane B Carson D.O. has the Individual type.

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1710917299 NPI number is provided on an as is basis without warranty of any kind. 1710917299 is maintained by the National Plan & Provider Enumeration System. The contents of Shane B Carson D.O. are for informational purposes only.