Healthcare Provider Details

I. General information

NPI: 1447590120
Provider Name (Legal Business Name): JUSTICE FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 09/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7106 W HOOD PLACE
KENNEWICK WA
99336
US

IV. Provider business mailing address

7106 W HOOD PLACE
KENNEWICK WA
99336
US

V. Phone/Fax

Practice location:
  • Phone: 563-676-5454
  • Fax:
Mailing address:
  • Phone: 509-222-1132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH60314301
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License NumberCH60314300
License Number StateWA

VIII. Authorized Official

Name: DR. LINDSAY JUSTICE
Title or Position: MEMBER
Credential: DC
Phone: 509-222-1132