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General NPI Number Information
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NPI Number | 1285256602
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Entity Type | Organization
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Legal Business Name | KOTLERMAN FAMILY HEALTH LLC
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Dates
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Enumeration Date | 05/07/2020
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 320 E FAIRHAVEN AVE STE 209
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City | BURLINGTON
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State | WA
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Zip | 98233-1700
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Country | US
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Telephone | 360-661-9029
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 GREENLEAF AVE
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City | BURLINGTON
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State | WA
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Zip | 98233-2017
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Country | US
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Telephone | 310-663-5265
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ZACHARY KOTLERMAN
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Credential | DC
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Telephone | 310-663-5265
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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 |
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License Number State |
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