Provider Demographics
NPI:1306214598
Name:CHIROPRACTIC SYNERGY LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC SYNERGY LLC
Other - Org Name:CHIROSYNERGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN-NAM
Authorized Official - Middle Name:THANH
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-552-8351
Mailing Address - Street 1:12737 BEL RED RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2699
Mailing Address - Country:US
Mailing Address - Phone:206-552-8351
Mailing Address - Fax:206-858-8278
Practice Address - Street 1:12737 BEL RED RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2699
Practice Address - Country:US
Practice Address - Phone:206-552-8351
Practice Address - Fax:206-858-8278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60504206302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization