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General NPI Number Information
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NPI Number | 1164970778
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Entity Type | Organization
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Legal Business Name | CENTRAL WELLNESS CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 1400 20TH AVE
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City | SEATTLE
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State | WA
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Zip | 98122-2802
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Country | US
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Telephone | 206-323-0114
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Fax | 844-329-1722
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Provider Business Mailing Address
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Address Line | 1400 20TH AVE
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City | SEATTLE
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State | WA
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Zip | 98122-2802
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Country | US
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Telephone | 206-323-0114
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Fax | 844-329-1722
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. JEFFREY WORD
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Credential |
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Telephone | 206-323-0114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | CH60239267
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License Number State | WA
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