Provider Demographics
NPI:1003123704
Name:CARLSBORG CHIROPRACTIC CENTER, PLLC
Entity Type:Organization
Organization Name:CARLSBORG CHIROPRACTIC CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GEIGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-683-4824
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:CARLSBORG
Mailing Address - State:WA
Mailing Address - Zip Code:98324-0115
Mailing Address - Country:US
Mailing Address - Phone:360-683-4824
Mailing Address - Fax:360-683-4824
Practice Address - Street 1:863 CARLSBORG RD STE C
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-6962
Practice Address - Country:US
Practice Address - Phone:360-683-4824
Practice Address - Fax:360-683-4824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60147311111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty