Provider Demographics
NPI:1558631796
Name:ISLAND HEALTH AND CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:ISLAND HEALTH AND CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VRACIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-605-0179
Mailing Address - Street 1:9431 COPPERTOP LOOP NE STE 204
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-3684
Mailing Address - Country:US
Mailing Address - Phone:206-842-6655
Mailing Address - Fax:206-842-6677
Practice Address - Street 1:9431 COPPERTOP LOOP NE STE 204
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-3684
Practice Address - Country:US
Practice Address - Phone:206-842-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty