Individual
KIRK W PETHERAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
701 WINSLOW WAY E STE B, BAINBRIDGE ISLAND, WA 98110-2416
(206) 842-2702
Mailing address
701 WINSLOW WAY E STE B, BAINBRIDGE ISLAND, WA 98110-2416
(206) 842-2702
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
22433
CA
111N00000X
Chiropractor
Primary
3554
WA
Other
Enumeration date
03/07/2007
Last updated
01/12/2012
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