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NPI Code Detail

MEDICARE: LINDA JEAN DEGROOT D.C.

MEDICARE:   LINDA JEAN DEGROOT  D.C.
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
1111N00000XChiropractorCH00002149WA

General Provider Information

NPI Number : 1912051822
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA JEAN DEGROOT D.C.
Provider Business Mailing Address
First Line : 20536 108TH AVE SE
Second Line :
City : KENT
State : WA
Zip : 98031-1542
Country : US
Telephone Number : 253-854-7711
Fax Number : 253-858-4792
Provider Business Practice Location Address
First Line : 20536 108TH AVE SE
Second Line :
City : KENT
State : WA
Zip : 98031-1542
Country : US
Telephone Number : 253-854-7711
Fax Number : 253-858-4792
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 11/18/2011

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Directions to “ LINDA JEAN DEGROOT D.C.” Practice Location

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