Healthcare Provider Details

I. General information

NPI: 1093173049
Provider Name (Legal Business Name): CHIROBODY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 07/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10315 19TH AVE SE SUITE 106
EVERETT WA
98208-4268
US

IV. Provider business mailing address

10315 19TH AVE SE SUITE 106
EVERETT WA
98208-4268
US

V. Phone/Fax

Practice location:
  • Phone: 425-338-5537
  • Fax: 844-783-6456
Mailing address:
  • Phone: 425-338-5537
  • Fax: 844-783-6456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH 602551862
License Number StateWA

VIII. Authorized Official

Name: DR. ANTHONY ARREOLA
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 425-338-5537