Covington Chiropractic Llc | |
26708 180th Ave Se Suite102 Covington WA 98042-4969 | |
(253) 630-9777 | |
(253) 630-9806 |
Full Name | Covington Chiropractic Llc |
---|---|
Speciality | Clinic/Center |
Location | 26708 180th Ave Se, Covington, Washington |
Authorized Official Name and Position | Neal Booher Vitalis (OWNER) |
Authorized Official Contact | 2536309777 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Covington Chiropractic Llc 26708 180th Ave Se Suite102 Covington WA 98042-4969 Ph: (253) 630-9777 | Covington Chiropractic Llc 26708 180th Ave Se Suite102 Covington WA 98042-4969 Ph: (253) 630-9777 |
NPI Number | 1538400031 |
---|---|
Provider Enumeration Date | 03/07/2013 |
Last Update Date | 03/07/2013 |
Medicare PECOS PAC ID | 1557508587 |
---|---|
Medicare Enrollment ID | O20130513000186 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538400031 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | CH00002179 (Washington) | Primary |
Provider Name | Neal B Vitalis |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1528165628 PECOS PAC ID: 5799700746 Enrollment ID: I20051010000562 |
Proliance Orthopedic Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 27005 168th Pl Se Ste 201, Covington, WA 98042 Phone: 253-630-3660 Fax: 253-631-1591 |