| NPI | 1972723641 |
|---|---|
| Doing Business As | STATE STREET FAMILY CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | GORDON A MYCO Chiropractor Owner 360-653-6010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00003460) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2009-01-06 |