Provider Demographics
NPI:1477570489
Name:TONY GARENT CHIROPRACTIC CLINIC P.L.L.C.
Entity Type:Organization
Organization Name:TONY GARENT CHIROPRACTIC CLINIC P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARENT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-697-4838
Mailing Address - Street 1:9 E 1ST AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-1400
Mailing Address - Country:US
Mailing Address - Phone:509-697-4838
Mailing Address - Fax:509-697-6132
Practice Address - Street 1:9 E 1ST AVE STE 1
Practice Address - Street 2:
Practice Address - City:SELAH
Practice Address - State:WA
Practice Address - Zip Code:98942-1400
Practice Address - Country:US
Practice Address - Phone:509-697-4838
Practice Address - Fax:509-697-6132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033953111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1184641185OtherNPI
WA2024636Medicaid
WAAB24480Medicare PIN
WAAB19201Medicare ID - Type Unspecified
WA2024636Medicaid