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General NPI Number Information
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NPI Number | 1154532042
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Entity Type | Organization
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Legal Business Name | ATLAS CHIROPRACTIC CLINIC, LLC
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 14608 HWY 99 SUITE309
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City | LYNNWOOD
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State | WA
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Zip | 98087
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Country | US
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Telephone | 425-742-0332
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Fax | 425-742-4160
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Provider Business Mailing Address
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Address Line | 14608 HWY 99 SUITE309
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City | LYNNWOOD
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State | WA
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Zip | 98037
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Country | US
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Telephone | 425-742-0332
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Fax | 425-742-4160
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JINYOUNG KIM
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Credential |
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Telephone | 425-742-0332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00034110
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License Number State | WA
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