Organization Name: | PEARL CHIROPRACTIC, PS |
NPI Number: | 1124360201 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CORENE K BODILY-GOODMANSEN (OWNER) |
Mailing Address: | 5929 Westgate Blvd Suite C Tacoma |
State: | WA US |
Postal Code: | 984062567 |
Phone Number: | 2539705077 |
Fax Number: | 2533271296 |
NPI Enumeration Date: | 03/26/2013 |
NPI Last Update Date: | 03/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA00023725 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |