Brilliant Life Chiropractic, LLC
Chiropractor in Tacoma, WA. Organization (NPI-2).
NPI number1063666444
StatusActive
Last updated in NPPESJan 14, 2020
Details
- NPI
- 1063666444
- Entity type
- Organization (NPI-2)
- Legal business name
- Brilliant Life Chiropractic, LLC
- Organization subpart
- No
- Enumeration date
- Nov 11, 2008
- Certification date
- Jan 14, 2020
- Last updated
- Jan 14, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | CH00034780 | WA | Yes |
| 111N00000X | Chiropractor | CH00034834 | WA |
Practice location
708 Broadway Ste 403Tacoma, WA 98402
Phone 253-383-0577 · Fax 253-383-0574
Mailing address
708 Broadway Ste 403Tacoma, WA 98402-3781
Phone 253-383-0577 · Fax 253-383-0574
Other practice locations
2610 6th Ave
Tacoma, WA 98406-7205
Tacoma, WA 98406-7205
Phone 253-383-0577 · Fax 253-383-0574
2610 6th Ave
Tacoma, WA 98406-7205
Tacoma, WA 98406-7205
Phone 253-383-0577 · Fax 253-383-0574
Authorized official
Paul William Martin
Owner
2533830577
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