Organization
COUNTRY CHIROPRACTIC CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AVERY NEIL MARTIN DC (OWNER)
(360) 856-5562
Entity
Organization
Contact information
Practice address
22790 BUCHANAN ST, MOUNT VERNON, WA 98273-8023
(360) 856-5562
(360) 856-4923
Mailing address
PO BOX 508, CLEARLAKE, WA 98235-0508
(360) 856-5562
(360) 856-4923
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1315
WA
Other
Enumeration date
03/13/2007
Last updated
05/22/2008
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