Organization
VAN FLEET CHIROPRACTIC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLINTON W VAN FLEET JR. DC (CHIROPRACTOR)
(360) 423-2037
Entity
Organization
Contact information
Practice address
1060 HUDSON ST, LONGVIEW, WA 98632-3103
(360) 423-2037
(360) 423-9320
Mailing address
1060 HUDSON ST, LONGVIEW, WA 98632-3103
(360) 423-2037
(360) 423-9320
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004892
L&I
—
01
—
2007250
DSHS
—
01
—
350030478
RAILROAD MM
WA
01
—
8920472
CRIME VICTIMS
WA
01
—
G000700204
MEDICARE
WA
01
—
T02610
UPIN
WA
Enumeration date
02/22/2011
Last updated
10/05/2016
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