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General NPI Number Information
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NPI Number | 1801113378
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Entity Type | Organization
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Legal Business Name | BODYFIT CHIROPRACTIC
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 14415 SE MILL PLAIN BLVD STE 120C
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City | VANCOUVER
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State | WA
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Zip | 98684-6996
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Country | US
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Telephone | 360-944-0050
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Fax | 360-885-1212
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Provider Business Mailing Address
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Address Line | 14415 SE MILL PLAIN BLVD STE 120C
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City | VANCOUVER
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State | WA
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Zip | 98684-6996
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Country | US
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Telephone | 360-944-0050
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Fax | 360-885-1212
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PERRIN HAYWOOD GUYTON III
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Credential | D.C.
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Telephone | 360-944-0050
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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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