Provider Demographics
NPI:1922405356
Name:COMPLETE CHIROPRACTIC & MASSAGE LLC
Entity Type:Organization
Organization Name:COMPLETE CHIROPRACTIC & MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-507-4631
Mailing Address - Street 1:1310 S UNION AVE
Mailing Address - Street 2:SUITE A-202
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1907
Mailing Address - Country:US
Mailing Address - Phone:253-507-4631
Mailing Address - Fax:
Practice Address - Street 1:1310 S UNION AVE
Practice Address - Street 2:SUITE A-202
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1907
Practice Address - Country:US
Practice Address - Phone:253-507-4631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60385836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty