Provider Demographics
NPI:1740912500
Name:AVISE CHIROPRACTIC P L L C
Entity type:Organization
Organization Name:AVISE CHIROPRACTIC P L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANH THU
Authorized Official - Middle Name:HOANG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-293-2444
Mailing Address - Street 1:4017 A ST SE # B101
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-8607
Mailing Address - Country:US
Mailing Address - Phone:253-939-8144
Mailing Address - Fax:253-939-2289
Practice Address - Street 1:4017 A ST SE # B101
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-8607
Practice Address - Country:US
Practice Address - Phone:253-939-8144
Practice Address - Fax:253-939-2289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty