Provider Demographics
NPI:1871938332
Name:NEW START CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:NEW START CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DDAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-712-0307
Mailing Address - Street 1:22315 HIGHWAY 99 STE B
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8065
Mailing Address - Country:US
Mailing Address - Phone:425-712-0307
Mailing Address - Fax:425-749-7102
Practice Address - Street 1:22315 HIGHWAY 99 STE B
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8065
Practice Address - Country:US
Practice Address - Phone:425-712-0307
Practice Address - Fax:425-749-7102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034226261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center