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General NPI Number Information
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NPI Number | 1265668628
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Entity Type | Organization
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Legal Business Name | ABSOLUTE CHIROPRACTIC INC
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Dates
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Enumeration Date | 05/29/2009
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Last Update Date | 05/01/2014
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Provider Practice Location Address
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Address Line | 312 GARDNER RD
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City | BURLINGTON
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State | WA
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Zip | 98233-1531
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Country | US
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Telephone | 360-757-7463
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Fax | 360-757-7171
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Provider Business Mailing Address
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Address Line | 312 GARDNER RD
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City | BURLINGTON
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State | WA
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Zip | 98233-1531
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Country | US
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Telephone | 360-757-7463
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Fax | 360-757-6117
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Authorized Official
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Title or Position | PRESIDENT CORPORATION
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Name | DR. LINDA LU CLEMENS
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Credential | D.C.
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Telephone | 360-757-7463
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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 | CH00002949
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License Number State | WA
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