Healthcare Provider Details

I. General information

NPI: 1407905300
Provider Name (Legal Business Name): CHENEY SPINAL CARE PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 1ST ST
CHENEY WA
99004-2000
US

IV. Provider business mailing address

1951 1ST ST
CHENEY WA
99004-2000
US

V. Phone/Fax

Practice location:
  • Phone: 509-235-2122
  • Fax: 509-235-2444
Mailing address:
  • Phone: 509-235-2122
  • Fax: 509-235-2444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00034406
License Number StateWA

VIII. Authorized Official

Name: DR. ROBERT F COLLINS
Title or Position: PRESIDEN
Credential: DC
Phone: 509-235-2122