Provider Demographics
NPI:1205855335
Name:COUGH, ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:COUGH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 N PINES RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4900
Mailing Address - Country:US
Mailing Address - Phone:509-924-9990
Mailing Address - Fax:509-924-9990
Practice Address - Street 1:905 N PINES RD
Practice Address - Street 2:SUITE C
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4900
Practice Address - Country:US
Practice Address - Phone:509-924-9990
Practice Address - Fax:509-924-9990
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor