Organization
PUYALLUP WELLNESS PLLC
Active
Other names
Active Chiropractic & Massage
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY MUNDT DC (CLINIC DIRECTOR)
(253) 473-3733
Entity
Organization
Contact information
Practice address
2802 S MERIDIAN, PUYALLUP, WA 98373-1402
(253) 445-5032
(253) 845-0129
Mailing address
2802 S MERIDIAN, PUYALLUP, WA 98373-1402
(253) 445-5032
(253) 845-0129
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
171100000X
Acupuncturist
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G8945973
—
WA
Enumeration date
11/12/2019
Last updated
11/12/2019
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