Organization
ADVANCED CHIROPRACTIC CENTRE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LEE WASILENKOFF D.C (OWNER)
(360) 892-3654
Entity
Organization
Contact information
Practice address
705 SE PARK CREST AVE., STE A120, VANCOUVER, WA 98683-1303
(360) 892-3654
(360) 892-3692
Mailing address
705 SE PARK CREST AVE., STE A120, VANCOUVER, WA 98683-1303
(360) 892-3654
(360) 892-3692
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
CH00003418
WA
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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