Provider Demographics
NPI:1912236555
Name:BUCLAW, LLC
Entity Type:Organization
Organization Name:BUCLAW, LLC
Other - Org Name:AGLA CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER-MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BUCLAW
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:253-632-5320
Mailing Address - Street 1:P.O. BOX 23955
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98093
Mailing Address - Country:US
Mailing Address - Phone:253-632-5320
Mailing Address - Fax:253-214-7444
Practice Address - Street 1:1707 S 341ST PL STE A
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6867
Practice Address - Country:US
Practice Address - Phone:253-632-5320
Practice Address - Fax:253-214-7444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034618111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0346488OtherWA STATE LABOR AND INDUSTRIES PIN
WAG8934291Medicare PIN