Provider Demographics
NPI:1548844749
Name:TACOMA MALL CHIROPRACTIC
Entity type:Organization
Organization Name:TACOMA MALL CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HALABI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-520-2529
Mailing Address - Street 1:PO BOX 6609
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98064-6609
Mailing Address - Country:US
Mailing Address - Phone:253-212-0907
Mailing Address - Fax:253-267-1405
Practice Address - Street 1:2115 S 56TH ST STE 101
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-6900
Practice Address - Country:US
Practice Address - Phone:253-212-0907
Practice Address - Fax:253-267-1405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty