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General NPI Number Information
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NPI Number | 1083089387
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Entity Type | Organization
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Legal Business Name | RIVERWALK FAMILY CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 12/11/2015
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Last Update Date | 12/11/2015
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Provider Practice Location Address
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Address Line | 100 E 9TH ST
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City | WENATCHEE
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State | WA
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Zip | 98801-1505
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Country | US
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Telephone | 509-888-1099
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Fax | 509-888-2068
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Provider Business Mailing Address
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Address Line | 100 E 9TH ST
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City | WENATCHEE
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State | WA
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Zip | 98801-1505
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Country | US
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Telephone | 509-888-1099
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Fax | 509-888-2068
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS G KOCH
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Credential | DC
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Telephone | 509-433-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 603554608
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License Number State | WA
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