Organization
CHURCH CHIROPRACTIC INC
Active
Organization
CHURCH CHIROPRACTIC INC
Active
Other names
HEALTHSOURCE OF PUYALLUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL L CHURCH DC (PRESIDENT)
(253) 841-4425
Entity
Organization
Contact information
Practice address
1703 S MERIDIAN, SUITE 301, PUYALLUP, WA 98371-7590
(253) 841-4425
Mailing address
PO BOX 1272, SUMNER, WA 98390-0250
(253) 841-4425
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
CH3323
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
169571
WORK COMP
WA
Enumeration date
06/25/2008
Last updated
11/06/2014
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