Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH00001743 | WA |
NPI | 1558396242 |
---|---|
Provider Name | Dr. Howard W Friedly |
First Address | Lacey, WA 98509 |
Second Address | Lacey, WA 98503-5730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 18/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T02703 | (02) | WA |