Provider Demographics
NPI:1720893779
Name:GRIT SPINE AND SPORTS THERAPY LLC
Entity type:Organization
Organization Name:GRIT SPINE AND SPORTS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACHARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-280-9669
Mailing Address - Street 1:15645 10TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2109
Mailing Address - Country:US
Mailing Address - Phone:206-280-9669
Mailing Address - Fax:
Practice Address - Street 1:2108 SW 152ND ST STE H
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2069
Practice Address - Country:US
Practice Address - Phone:206-486-0390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty