Provider Demographics
NPI:1033451851
Name:RICK FOLKMAN DC LLC
Entity Type:Organization
Organization Name:RICK FOLKMAN DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:FOLKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-582-3549
Mailing Address - Street 1:1721 W KENNEWICK AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336
Mailing Address - Country:US
Mailing Address - Phone:509-582-3549
Mailing Address - Fax:
Practice Address - Street 1:1721 W KENNEWICK AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336
Practice Address - Country:US
Practice Address - Phone:509-582-3549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034015111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8920420OtherMEDICARE NUMBER