Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 3336 | WA |
NPI | 1083729651 |
---|---|
Provider Name | Dr. Brian A Mather |
First Address | Spokane, WA 99218-1319 |
Second Address | Spokane, WA 99218-1903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 12/07/2017 |