Provider Demographics
NPI:1942696638
Name:CORE CHIROPRACTIC CLINIC, P.S.
Entity Type:Organization
Organization Name:CORE CHIROPRACTIC CLINIC, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:FLOCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-249-8291
Mailing Address - Street 1:330 W PIONEER AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MONTESANO
Mailing Address - State:WA
Mailing Address - Zip Code:98563-4412
Mailing Address - Country:US
Mailing Address - Phone:360-249-8291
Mailing Address - Fax:360-249-8351
Practice Address - Street 1:330 W PIONEER AVE STE C
Practice Address - Street 2:
Practice Address - City:MONTESANO
Practice Address - State:WA
Practice Address - Zip Code:98563-4412
Practice Address - Country:US
Practice Address - Phone:360-249-8291
Practice Address - Fax:360-249-8351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty