| NPI | 1174877955 |
|---|---|
| Doing Business As | ACTIVE LIFE CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | KRISTINA LYNN COPPOCK Owner/Doctor/Office Manager 509-965-9820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: WA CH60309681) |
| Additional Taxonomies | 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: WA CH60309681) |
| 111NS0005X Chiropractor, Sports Physician (Licence: WA CH60309678) | |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2012-11-01 |