Provider Demographics
NPI:1457521387
Name:ZOGRAFOS CHIROPRACTIC CENTER PS
Entity Type:Organization
Organization Name:ZOGRAFOS CHIROPRACTIC CENTER PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ZOGRAFOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCO
Authorized Official - Phone:509-928-5100
Mailing Address - Street 1:8921 E ALKI AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2705
Mailing Address - Country:US
Mailing Address - Phone:509-928-5100
Mailing Address - Fax:509-928-1651
Practice Address - Street 1:8921 E ALKI AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2705
Practice Address - Country:US
Practice Address - Phone:509-928-5100
Practice Address - Fax:509-928-1651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001073111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG000301781Medicare PIN
WAT02417Medicare UPIN
WADN3257Medicare PIN