Provider Demographics
NPI:1235256918
Name:IROC PS
Entity Type:Organization
Organization Name:IROC PS
Other - Org Name:LATIMER INTEGRATIVE CHIROPRACTIC & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:LATIMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-884-4357
Mailing Address - Street 1:603 N MISSION ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801
Mailing Address - Country:US
Mailing Address - Phone:509-884-4357
Mailing Address - Fax:509-888-4601
Practice Address - Street 1:603 N MISSION ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801
Practice Address - Country:US
Practice Address - Phone:509-884-4357
Practice Address - Fax:509-888-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X, 171100000X, 175F00000X, 225100000X, 225700000X, 363A00000X
WA3606111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD 00024041OtherDR. BATSON'S MED. LICENSE
WA1245394253OtherDR. BATSON'S NPI #
WACH00000 3031OtherDR. LATIMER'S DC LICENSE
WA1679615678OtherDR. LATIMER'S NIP #