Provider Demographics
NPI:1669696571
Name:GUTHRIE CHIROPRACTIC
Entity type:Organization
Organization Name:GUTHRIE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:P
Authorized Official - Last Name:GUTHRIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-327-8188
Mailing Address - Street 1:4703 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-5500
Mailing Address - Country:US
Mailing Address - Phone:509-327-8188
Mailing Address - Fax:509-327-8182
Practice Address - Street 1:4703 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-5500
Practice Address - Country:US
Practice Address - Phone:509-327-8188
Practice Address - Fax:509-327-8182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU87579Medicare UPIN
WAGAB18638Medicare PIN