Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH00001108 | WA |
NPI | 1003869181 |
---|---|
Provider Name | Dr. Gregory Charles Bartlett |
First Address | Tacoma, WA 98402-4800 |
Second Address | Tacoma, WA 98402-4800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 08/07/2007 |