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NPI Code Detail

MEDICARE: MONROE CHIROPRACTIC AND MASSAGE

MEDICARE: MONROE CHIROPRACTIC AND MASSAGE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist
2111N00000XChiropractor

General Provider Information

NPI Number : 1043610116
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONROE CHIROPRACTIC AND MASSAGE
Provider Business Mailing Address
First Line : 1233 W MAIN ST
Second Line :
City : MONROE
State : WA
Zip : 98272-2028
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1233 W MAIN ST
Second Line :
City : MONROE
State : WA
Zip : 98272-2028
Country : US
Telephone Number : 360-794-7115
Fax Number :
Authorized Official
Title or Position : OWNER
Name : WILLIAM LANCE EBLEN
Credential :
Telephone Number : 360-794-7115
Provider Enumeration Date : 08/26/2014
Last Update Date : 08/26/2014

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Directions to “MONROE CHIROPRACTIC AND MASSAGE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.