Provider Demographics
NPI:1104672864
Name:IMPACT ACCIDENT & INJURY CHIROPRACTIC
Entity type:Organization
Organization Name:IMPACT ACCIDENT & INJURY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MCGHIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-806-8277
Mailing Address - Street 1:13030 MILITARY RD S STE 106
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-3079
Mailing Address - Country:US
Mailing Address - Phone:206-806-8277
Mailing Address - Fax:206-923-7601
Practice Address - Street 1:13030 MILITARY RD S STE 106
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-3079
Practice Address - Country:US
Practice Address - Phone:206-806-8277
Practice Address - Fax:206-923-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty