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General NPI Number Information
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NPI Number | 1568737047
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Entity Type | Organization
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Legal Business Name | PAIN FREE MOVE WELL
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Dates
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Enumeration Date | 03/15/2012
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 21907 64TH AVE W STE 110
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-2298
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Country | US
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Telephone | 425-774-6876
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Fax | 425-775-2739
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Provider Business Mailing Address
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Address Line | 21907 64TH AVE W STE 110
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-2298
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Country | US
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Telephone | 425-774-6876
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Fax | 425-775-2739
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL WARREN GROVES
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Credential | D.C.
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Telephone | 425-802-3391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00034535
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License Number State | WA
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