Provider Demographics
NPI:1518042399
Name:MANA CHIROPRACTIC P.S.
Entity Type:Organization
Organization Name:MANA CHIROPRACTIC P.S.
Other - Org Name:MURRY CHIROPRACTIC CLINIC, P.S.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DYLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-734-9525
Mailing Address - Street 1:412 GIRARD ST.
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4004
Mailing Address - Country:US
Mailing Address - Phone:360-734-9525
Mailing Address - Fax:360-734-9505
Practice Address - Street 1:412 GIRARD ST.
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4004
Practice Address - Country:US
Practice Address - Phone:360-734-9525
Practice Address - Fax:360-734-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033920111N00000X
111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty