Chelan Spine LLC
Organization Active NPI Chiropractor · Chelan, WA
NPI 1295249605 · NPPES record last updated Nov 21, 2017
Key facts
- NPI
- 1295249605
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 60799138 (WA)
- Legal business name
- CHELAN SPINE LLC
- Practice address
- 130 E Chelan Avenue
Chelan, WA 98816 - Phone
- (509) 682-4078
- NPI assigned
- Nov 21, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Brandon Fromm, D.C.
- Title
- Owner
- Phone
- (509) 859-5921
Practitioners 8
-
Brandon Fromm, DC
-
Francisco Blanco, LMT
-
Marc William Golden, LMP
-
Skyler Gouldin, D.C.
-
Bruce F Hurst, DC
-
Beverly Ann Peters, LMP
-
Tiffany Rae Simmons, LMP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171207000745 | WA | Part B Supplier - Clinic/Group Practice | 8022375617 |
Receives reassigned benefits from 2 practitioners Practice locations: Chelan, WA |
National Provider Directory
Locations
2133 W Woodin Ave
Chelan, WA 98816
Phone (509) 682-4078
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 60799138 | WA | Yes |
Addresses
Primary practice location
130 E Chelan Avenue
Chelan, WA 98816
Mailing address
PO Box 2888
Chelan, WA 98816-2888
Phone (509) 859-5921
Other names
- Lakeland Chiropractic
Other providers in Chelan, WA
- Chelan County Public Hospital District No 2
- Chelan County Public Hospital District No 2
- Chelan County Public Hospital District No 2
- Chelan County Public Hospital District No. 2
- Chelan County Pulblic Hospital Dist #2
- Chelan-Okanogan Foot & Ankle
- Robin Lynne Collins
- Columbia Valley Community Health
- Kami L Copenhaver
- Samantha Delores Courtney
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.