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NPI Code Detail

MEDICARE: FOX CHIROPRACTIC WELLNESS CENTER PS

MEDICARE: FOX CHIROPRACTIC WELLNESS CENTER PS
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
1261QH0100XHealth Service Clinic/CenterCH0001303WA

General Provider Information

NPI Number : 1295990703
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOX CHIROPRACTIC WELLNESS CENTER PS
Provider Business Mailing Address
First Line : 3715 56TH ST NW
Second Line :
City : GIG HARBOR
State : WA
Zip : 98335-8240
Country : US
Telephone Number : 253-851-5138
Fax Number :
Provider Business Practice Location Address
First Line : 3715 56TH ST NW
Second Line :
City : GIG HARBOR
State : WA
Zip : 98335-8240
Country : US
Telephone Number : 253-851-5138
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. GREGORY LYLE FOX
Credential : D.C.
Telephone Number : 253-851-5138
Provider Enumeration Date : 07/23/2008
Last Update Date : 07/23/2008

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Directions to “FOX CHIROPRACTIC WELLNESS CENTER PS ” Practice Location

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