Provider Demographics
NPI:1831750876
Name:LONG CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:LONG CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-525-5664
Mailing Address - Street 1:5901 ROOSEVELT WAY NE STE 101A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2763
Mailing Address - Country:US
Mailing Address - Phone:206-525-5664
Mailing Address - Fax:206-525-6106
Practice Address - Street 1:5901 ROOSEVELT WAY NE STE 101A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-2763
Practice Address - Country:US
Practice Address - Phone:206-525-5664
Practice Address - Fax:206-525-6106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty