Provider Demographics
NPI:1952663700
Name:SYMMETRY CHIROPRACTIC WELLNESS CENTER INC PS
Entity Type:Organization
Organization Name:SYMMETRY CHIROPRACTIC WELLNESS CENTER INC PS
Other - Org Name:SYMMETRY CHIROPRACTIC WELLNESS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BROSSARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-750-5638
Mailing Address - Street 1:3710 168TH ST NE
Mailing Address - Street 2:A101
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8461
Mailing Address - Country:US
Mailing Address - Phone:360-722-1578
Mailing Address - Fax:
Practice Address - Street 1:3710 168TH ST NE
Practice Address - Street 2:A101
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8461
Practice Address - Country:US
Practice Address - Phone:360-722-1578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60262639261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service