Provider Demographics
NPI:1427175637
Name:DECAMP-TOFTNESS CHIROPRACTIC CLINIC, P.S.
Entity type:Organization
Organization Name:DECAMP-TOFTNESS CHIROPRACTIC CLINIC, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DECAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-662-4711
Mailing Address - Street 1:610 N MISSION ST STE C4
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-6612
Mailing Address - Country:US
Mailing Address - Phone:509-662-4711
Mailing Address - Fax:
Practice Address - Street 1:610 N MISSION ST STE C4
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6612
Practice Address - Country:US
Practice Address - Phone:509-662-4711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty