Provider Demographics
NPI:1285045021
Name:BODYFIT CHIROPRACTIC
Entity Type:Organization
Organization Name:BODYFIT CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:H
Authorized Official - Last Name:GUYTON
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:360-944-0050
Mailing Address - Street 1:406 SE 131ST AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-4031
Mailing Address - Country:US
Mailing Address - Phone:360-944-0050
Mailing Address - Fax:360-885-1212
Practice Address - Street 1:406 SE 131ST AVE STE 108
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-4031
Practice Address - Country:US
Practice Address - Phone:360-944-0050
Practice Address - Fax:360-885-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60170179225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty