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General NPI Number Information
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NPI Number | 1386818250
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Entity Type | Organization
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Legal Business Name | TODAY'S CHIROPRACTIC CLINIC, P.S.
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 614 S 225TH ST
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City | DES MOINES
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State | WA
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Zip | 98198-6843
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Country | US
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Telephone | 206-878-2225
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Fax | 206-878-7488
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Provider Business Mailing Address
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Address Line | 614 S 225TH ST
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City | DES MOINES
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State | WA
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Zip | 98198-6843
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Country | US
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Telephone | 206-878-2225
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Fax | 206-878-7488
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHARLES M LAYCOCK
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Credential | DC
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Telephone | 206-878-2225
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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 | 2398
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License Number State | WA
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