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General NPI Number Information
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NPI Number | 1740912500
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Entity Type | Organization
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Legal Business Name | AVISE CHIROPRACTIC P L L C
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 4017 A ST SE # B101
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City | AUBURN
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State | WA
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Zip | 98002-8607
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Country | US
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Telephone | 253-939-8144
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Fax | 253-939-2289
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Provider Business Mailing Address
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Address Line | 4017 A ST SE # B101
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City | AUBURN
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State | WA
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Zip | 98002-8607
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Country | US
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Telephone | 253-939-8144
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Fax | 253-939-2289
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANH THU HOANG NGUYEN
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Credential |
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Telephone | 253-293-2444
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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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