Provider Demographics
NPI:1710182746
Name:RANGEL CHIROPRACTIC GROUP, PLLC
Entity Type:Organization
Organization Name:RANGEL CHIROPRACTIC GROUP, PLLC
Other - Org Name:RANGEL CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT-MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:RUBEN
Authorized Official - Last Name:RANGEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:509-582-3549
Mailing Address - Street 1:2025 HARRIS AVE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2018
Mailing Address - Country:US
Mailing Address - Phone:509-582-3549
Mailing Address - Fax:
Practice Address - Street 1:1721 W KENNEWICK AVE STE 1A
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3377
Practice Address - Country:US
Practice Address - Phone:509-582-3549
Practice Address - Fax:509-586-4313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034536111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1326156738OtherNPI #