Provider Demographics
NPI:1396449351
Name:APEX CHIROPRACTIC AND REHAB LLC
Entity type:Organization
Organization Name:APEX CHIROPRACTIC AND REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PHANEUF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-739-5679
Mailing Address - Street 1:2120 GRANT ST STE 7
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4223
Mailing Address - Country:US
Mailing Address - Phone:360-347-1475
Mailing Address - Fax:360-933-5727
Practice Address - Street 1:2120 GRANT ST STE 7
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4223
Practice Address - Country:US
Practice Address - Phone:360-347-1475
Practice Address - Fax:360-933-5727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1770298077Medicaid
WA1235553058Medicaid