| NPI | 1790261444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE TROXLER Credentialing Specialist 425-355-5222 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2023-08-18 |