| NPI | 1144592981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARENCE NATHAN LEAVITT Chiropractor 360-676-9533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA 2163) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-08 |