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General NPI Number Information
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NPI Number | 1477259778
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Entity Type | Organization
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Legal Business Name | RENOVO CHIROPRACTIC & WELLNESS LLC
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 914 D ST NE STE 101
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City | AUBURN
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State | WA
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Zip | 98002-4163
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Country | US
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Telephone | 253-939-0906
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Fax | 253-939-3381
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Provider Business Mailing Address
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Address Line | 914 D ST NE STE 101
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City | AUBURN
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State | WA
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Zip | 98002-4163
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Country | US
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Telephone | 253-939-0906
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Fax | 253-939-3381
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Authorized Official
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Title or Position | PRESIDENT
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Name | JESSICA BARENG-BARROS
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Credential | DC
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Telephone | 253-939-0906
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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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