Provider Demographics
NPI:1053680348
Name:TERRY FAMILY CHIROPRACTIC PS
Entity Type:Organization
Organization Name:TERRY FAMILY CHIROPRACTIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-527-9722
Mailing Address - Street 1:4340 PACIFIC HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-9017
Mailing Address - Country:US
Mailing Address - Phone:360-527-9722
Mailing Address - Fax:360-527-2713
Practice Address - Street 1:4340 PACIFIC HWY STE 103
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-9017
Practice Address - Country:US
Practice Address - Phone:360-527-9722
Practice Address - Fax:360-527-2713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty