Provider Demographics
NPI:1902530009
Name:ROYLANCE CHIROPRACTIC
Entity type:Organization
Organization Name:ROYLANCE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYLANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-855-6482
Mailing Address - Street 1:109 ASTRO LN NE
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-9022
Mailing Address - Country:US
Mailing Address - Phone:509-855-6482
Mailing Address - Fax:
Practice Address - Street 1:1342 S PIONEER WAY
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-2410
Practice Address - Country:US
Practice Address - Phone:509-855-6482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty