| NPI | 1063677573 |
|---|---|
| Doing Business As | FOURTH STREET CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | DENNIS LEO BOOTH Operating Manager 360-659-2938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: WA CH00002945) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-07-24 |