Provider Demographics
NPI:1366632911
Name:RAAB CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:RAAB CHIROPRACTIC, LLC
Other - Org Name:RAAB CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:RAAB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-327-8005
Mailing Address - Street 1:1020 W FRANCIS AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6637
Mailing Address - Country:US
Mailing Address - Phone:509-327-8005
Mailing Address - Fax:509-327-7869
Practice Address - Street 1:1020 W FRANCIS AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6637
Practice Address - Country:US
Practice Address - Phone:509-327-8005
Practice Address - Fax:509-327-7869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034781111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8873663Medicare PIN