Provider Demographics
NPI:1912761750
Name:UNIVERSITY CHIROPRACTIC SERVICES
Entity Type:Organization
Organization Name:UNIVERSITY CHIROPRACTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-982-4458
Mailing Address - Street 1:13701 E SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOILANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216
Mailing Address - Country:US
Mailing Address - Phone:509-922-4458
Mailing Address - Fax:509-922-8234
Practice Address - Street 1:UNIVERSITY CHIROPRACTIC
Practice Address - Street 2:13701 E SPRAGUE AVE
Practice Address - City:SPOILANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216
Practice Address - Country:US
Practice Address - Phone:509-922-4458
Practice Address - Fax:509-922-8234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty