Healthcare Provider Details
I. General information
NPI: 1144403304
Provider Name (Legal Business Name): SILVER CITY CHIROPRACTIC PS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2007
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3100 NW BUCKLIN HILL RD STE 101
SILVERDALE WA
98383-8359
US
IV. Provider business mailing address
3100 NW BUCKLIN HILL RD STE 101
SILVERDALE WA
98383-8359
US
V. Phone/Fax
- Phone: 360-613-5711
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 3599 |
| License Number State | WA |
VIII. Authorized Official
Name: DR.
JOSEPH
CHRISTMAN
Title or Position: PRESIDENT
Credential: D.C
Phone: 360-613-5711