Provider Demographics
NPI:1629251517
Name:DISCOVERY CHIROPRACTIC CLINIC, INC
Entity Type:Organization
Organization Name:DISCOVERY CHIROPRACTIC CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:A
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-885-1975
Mailing Address - Street 1:7904 NE 6TH AVE STE C
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8150
Mailing Address - Country:US
Mailing Address - Phone:360-885-1975
Mailing Address - Fax:360-253-9376
Practice Address - Street 1:7904 NE 6TH AVE
Practice Address - Street 2:STE C
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8150
Practice Address - Country:US
Practice Address - Phone:360-885-1975
Practice Address - Fax:360-253-9376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center