Healthcare Provider Details
I. General information
NPI: 1407037831
Provider Name (Legal Business Name): MARS HILL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/14/2007
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25854 108TH AVE SE
KENT WA
98030-7737
US
IV. Provider business mailing address
25854 108TH AVE SE
KENT WA
98030-7737
US
V. Phone/Fax
- Phone: 253-852-2828
- Fax: 253-852-2830
- Phone: 253-852-2828
- Fax: 253-852-2830
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NX0800X |
| Taxonomy | Orthopedic Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KURT
PETER
EBY
Title or Position: PRESIDENT
Credential: D.C.
Phone: 253-852-2828