Provider Demographics
NPI:1124736913
Name:NYREN CHIROPRACTIC CENTER, LLC
Entity type:Organization
Organization Name:NYREN CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:M
Authorized Official - Last Name:NYREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-588-9731
Mailing Address - Street 1:10828 GRAVELLY LAKE DR SW STE 108
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-1300
Mailing Address - Country:US
Mailing Address - Phone:253-588-9731
Mailing Address - Fax:253-588-9731
Practice Address - Street 1:10828 GRAVELLY LAKE DR SW STE 108
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-1300
Practice Address - Country:US
Practice Address - Phone:253-588-9731
Practice Address - Fax:253-588-9731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty