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General NPI Number Information
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NPI Number | 1699200642
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Entity Type | Organization
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Legal Business Name | LYNNWOOD FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | 16303 HIGHWAY 99 STE 1B
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City | LYNNWOOD
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State | WA
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Zip | 98087-1453
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Country | US
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Telephone | 425-743-9460
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Fax | 425-743-9409
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Provider Business Mailing Address
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Address Line | 16303 HIGHWAY 99 STE 1B
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City | LYNNWOOD
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State | WA
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Zip | 98087-1453
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Country | US
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Telephone | 425-743-9460
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Fax | 425-743-9409
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JOHN J SIM
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Credential | DC
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Telephone | 425-743-9460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60159932
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License Number State | WA
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