Organization
ELLENSBURG CHIROPRACTIC,PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY L. FAVERO DC (OWNER)
(509) 962-2225
Entity
Organization
Contact information
Practice address
109 S WATER ST, SUITE 2, ELLENSBURG, WA 98926-3061
(509) 962-2225
(509) 962-2270
Mailing address
109 S WATER ST, SUITE 2, ELLENSBURG, WA 98926-3061
(509) 962-2225
(509) 962-2270
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
WA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD00047820
WA
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
MD00047820
WA
225700000X
Massage Therapist
—
—
Other
Enumeration date
05/21/2010
Last updated
03/28/2012
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