Provider Demographics
NPI:1669019626
Name:RESTART CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:RESTART CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:F
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-501-6695
Mailing Address - Street 1:3830 A ST SE STE 204
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-8604
Mailing Address - Country:US
Mailing Address - Phone:253-245-1919
Mailing Address - Fax:
Practice Address - Street 1:3830 A ST SE STE 204
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-8604
Practice Address - Country:US
Practice Address - Phone:253-245-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESTART CHIROPRACTIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty