Provider Demographics
NPI:1881993855
Name:HULTMAN CHIROPRACTIC PS
Entity type:Organization
Organization Name:HULTMAN CHIROPRACTIC PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HULTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-367-5090
Mailing Address - Street 1:2611 NE 125TH ST
Mailing Address - Street 2:SUITE 247
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4373
Mailing Address - Country:US
Mailing Address - Phone:206-367-5090
Mailing Address - Fax:
Practice Address - Street 1:2611 NE 125TH ST
Practice Address - Street 2:SUITE 247
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4373
Practice Address - Country:US
Practice Address - Phone:206-367-5090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60186618111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty