Healthcare Provider Details

I. General information

NPI: 1942330758
Provider Name (Legal Business Name): J BRIAN ADDLEMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 VALLEY MALL PKWY SUITE 5
EAST WENATCHEE WA
98802-5348
US

IV. Provider business mailing address

100 VALLEY MALL PKWY SUITE 5
EAST WENATCHEE WA
98802-5348
US

V. Phone/Fax

Practice location:
  • Phone: 509-884-3368
  • Fax: 509-884-4720
Mailing address:
  • Phone: 509-884-3368
  • Fax: 509-884-4720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00001646
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: