Provider Demographics
NPI:1992031975
Name:FARB, LANA JEAN (PT)
Entity Type:Individual
Prefix:MRS
First Name:LANA
Middle Name:JEAN
Last Name:FARB
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11915 E BROADWAY AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4997
Mailing Address - Country:US
Mailing Address - Phone:509-921-7818
Mailing Address - Fax:509-891-0456
Practice Address - Street 1:11915 E BROADWAY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4997
Practice Address - Country:US
Practice Address - Phone:509-921-7818
Practice Address - Fax:509-891-0456
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1549-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist