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General NPI Number Information
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NPI Number | 1952448896
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Entity Type | Organization
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Legal Business Name | CONSTANTIN CHIROPRACTIC CLINIC PC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 2017 MAIN ST
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City | FERNDALE
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State | WA
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Zip | 98248-1992
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Country | US
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Telephone | 360-384-4611
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Fax | 360-384-2574
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Provider Business Mailing Address
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Address Line | PO BOX 1992
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City | FERNDALE
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State | WA
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Zip | 98248-1992
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Country | US
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Telephone | 360-384-4611
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Fax | 360-384-2574
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. PIERRE R CONSTANTIN
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Credential | DC
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Telephone | 360-384-4611
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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 | CH00002045
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License Number State | WA
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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 | CH00034646
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00001782
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License Number State | WA
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