Provider Demographics
NPI:1548647498
Name:FUEL SPINE & SPORTS THERAPY
Entity type:Organization
Organization Name:FUEL SPINE & SPORTS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-456-4550
Mailing Address - Street 1:4634 E MARGINAL WAY S
Mailing Address - Street 2:#C-120
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98134
Mailing Address - Country:US
Mailing Address - Phone:206-932-7943
Mailing Address - Fax:206-932-8686
Practice Address - Street 1:4634 E MARGINAL WAY S
Practice Address - Street 2:#C-120
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134
Practice Address - Country:US
Practice Address - Phone:206-932-7943
Practice Address - Fax:206-932-8686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty