Organization
FAMILY CHIROPRACTIC CARE BACK PAIN CLINIC PC
Active
Parent organization
FAMILY CHIROPRACTIC CARE BACK PAIN CLINIC PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY CHIROPRACTIC CARE BACK PAIN CLINIC PC
Authorized official
RICK D STILL D.C. (OWNER)
(360) 636-2636
Entity
Organization
Contact information
Practice address
1815 HUDSON STREET, LONGVIEW, WA 98632
(360) 636-2636
(360) 636-2621
Mailing address
1815 HUDSON STREET, LONGVIEW, WA 98632
(360) 636-2636
(360) 636-2621
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CH00001766
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11155590
CAQH
—
05
—
G000700235
—
WA
Enumeration date
04/21/2014
Last updated
04/21/2014
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