Organization
SSFC PS
Active
Other names
State Street Family Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON A MYCO DC (CHIROPRACTOR OWNER)
(360) 653-6010
Entity
Organization
Contact information
Practice address
919 STATE AVE STE 102, MARYSVILLE, WA 98270-4284
(360) 653-6010
(360) 653-6008
Mailing address
919 STATE AVE STE 102, MARYSVILLE, WA 98270-4284
(360) 653-6010
(360) 653-6008
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00003460
WA
Other
Enumeration date
04/26/2007
Last updated
01/06/2009
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