Provider Demographics
NPI:1609173970
Name:ANGLESEY FAMILY CHIROPRACTIC & MASSAGE CENTER
Entity Type:Organization
Organization Name:ANGLESEY FAMILY CHIROPRACTIC & MASSAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:D
Authorized Official - Last Name:ANGLESEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-927-8881
Mailing Address - Street 1:500 S PINES RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-5324
Mailing Address - Country:US
Mailing Address - Phone:509-927-8881
Mailing Address - Fax:509-891-6281
Practice Address - Street 1:500 S PINES RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-5324
Practice Address - Country:US
Practice Address - Phone:509-927-8881
Practice Address - Fax:509-891-6281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 34347111N00000X
WAMA00022059225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty