Provider Demographics
NPI:1235253568
Name:NOBLE SPORTS CHIROPRACTIC, P.S.
Entity Type:Organization
Organization Name:NOBLE SPORTS CHIROPRACTIC, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-671-7067
Mailing Address - Street 1:119 GRAND AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4400
Mailing Address - Country:US
Mailing Address - Phone:360-671-7067
Mailing Address - Fax:360-933-4045
Practice Address - Street 1:119 GRAND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4400
Practice Address - Country:US
Practice Address - Phone:360-671-7067
Practice Address - Fax:360-933-4045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH0034641261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA=========OtherFCHN IDENTIFIER