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General NPI Number Information
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NPI Number | 1184994949
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Entity Type | Organization
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Legal Business Name | CASHMERE VALLEY CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 207 WOODRING ST
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City | CASHMERE
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State | WA
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Zip | 98815-1035
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Country | US
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Telephone | 509-782-2050
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Fax | 509-782-2850
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Provider Business Mailing Address
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Address Line | 207 WOODRING ST
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City | CASHMERE
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State | WA
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Zip | 98815-1035
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Country | US
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Telephone | 509-782-2050
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Fax | 509-782-2850
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Authorized Official
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Title or Position | DR. OF CHIROPRACTIC
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Name | DR. KEITH WINSTON HENNING
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Credential | DC
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Telephone | 509-782-2050
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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 | 850
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License Number State | WA
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