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Organization

RAINIER CHIROPRACTIC CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSEPH DISPENZA D.C. (OWNER, CHIROPRACTOR)
(360) 400-3151
Entity
Organization

Contact information

Practice address
503 1ST ST S, YELM, WA 98597-7634
(360) 400-3151
(360) 400-3150
Mailing address
PO BOX 656, RAINIER, WA 98576-0656
(360) 400-3151
(360) 400-3150

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
601290297000
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0173734
L AND I CLINIC NUMBER
WA
Enumeration date
07/08/2006
Last updated
06/05/2011
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