Provider Demographics
NPI:1164713368
Name:BATTLE GROUND CHIROPRACTIC
Entity Type:Organization
Organization Name:BATTLE GROUND CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:STRAPPAZON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-687-3181
Mailing Address - Street 1:819 SE 14TH LOOP STE 125
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-4891
Mailing Address - Country:US
Mailing Address - Phone:360-687-3181
Mailing Address - Fax:360-687-1992
Practice Address - Street 1:819 SE 14TH LOOP STE 125
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-4891
Practice Address - Country:US
Practice Address - Phone:360-687-3181
Practice Address - Fax:360-687-1992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002552111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty