Provider Demographics
NPI:1093911844
Name:YARDLEY CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:YARDLEY CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:YARDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-529-1100
Mailing Address - Street 1:26238 PACIFIC HWY S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-6934
Mailing Address - Country:US
Mailing Address - Phone:253-529-1100
Mailing Address - Fax:253-529-9825
Practice Address - Street 1:26238 PACIFIC HWY S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-6934
Practice Address - Country:US
Practice Address - Phone:253-529-1100
Practice Address - Fax:253-529-9825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty