MEDICARE: MOUNTAIN VIEW CHIRORPACTIC PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor
2	111N00000X	Chiropractor	602561952	WA

General Provider Information

NPI Number	:	1245436476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNTAIN VIEW CHIRORPACTIC PLLC

Provider Business Mailing Address
First Line	:	9812 205TH AVE E STE C
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-8275
Country	:	US
Telephone Number	:	253-863-6378
Fax Number	:	253-863-6429

Provider Business Practice Location Address
First Line	:	9812 205TH AVE E STE C
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-8275
Country	:	US
Telephone Number	:	253-863-6378
Fax Number	:	253-863-6429

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. JOHN HUYNH
Credential	:	D.C.
Telephone Number	:	253-863-6378

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	06/06/2023

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