Provider Demographics
NPI:1942761317
Name:PUGET SOUND CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:PUGET SOUND CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUML
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-475-1910
Mailing Address - Street 1:212 S 37TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-7899
Mailing Address - Country:US
Mailing Address - Phone:253-475-1910
Mailing Address - Fax:
Practice Address - Street 1:212 S 37TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-7899
Practice Address - Country:US
Practice Address - Phone:253-475-1910
Practice Address - Fax:253-475-8279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty