Provider Demographics
NPI:1144604968
Name:BRIDGE CHIROPRACTIC 4 LLC
Entity Type:Organization
Organization Name:BRIDGE CHIROPRACTIC 4 LLC
Other - Org Name:PAUL REED SOLE MBR
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER & CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-574-5944
Mailing Address - Street 1:7317 E MILL PLAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1300
Mailing Address - Country:US
Mailing Address - Phone:360-695-4041
Mailing Address - Fax:360-693-2490
Practice Address - Street 1:7317 E MILL PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1300
Practice Address - Country:US
Practice Address - Phone:360-695-4041
Practice Address - Fax:360-693-2490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty