Provider Demographics
NPI:1447423868
Name:MEADOWPARK CHIROPRACTIC P.S., INC.
Entity Type:Organization
Organization Name:MEADOWPARK CHIROPRACTIC P.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANGELO
Authorized Official - Last Name:FRANDANISA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-582-2122
Mailing Address - Street 1:6923 LAKEWOOD DR W STE B3
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98467-3221
Mailing Address - Country:US
Mailing Address - Phone:253-582-2122
Mailing Address - Fax:
Practice Address - Street 1:6923 LAKEWOOD DR W STE B3
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98467-3221
Practice Address - Country:US
Practice Address - Phone:253-582-2122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACHOOOO2876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8805249Medicare PIN