Provider Demographics
NPI:1215191762
Name:THE CHIROPRACTIC PLACE, P.S.
Entity Type:Organization
Organization Name:THE CHIROPRACTIC PLACE, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-435-1285
Mailing Address - Street 1:11803 101ST AVE E STE 100
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3473
Mailing Address - Country:US
Mailing Address - Phone:253-435-1285
Mailing Address - Fax:253-445-8632
Practice Address - Street 1:11803 101ST AVE E STE 100
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3473
Practice Address - Country:US
Practice Address - Phone:253-435-1285
Practice Address - Fax:253-445-8632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH34275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty