| NPI | 1538465000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN CHRISTOPHER WICKSTROM Owner 509-342-9438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CHIRO.CH.60139083) |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2011-03-22 |