Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 025202CH00001132 | WA |
NPI | 1609885839 |
---|---|
Provider Name | Dr. Steven N. Jukich |
First Address | Spokane, WA 99205-6409 |
Second Address | Spokane, WA 99205-6409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T02509 | (02) | WA |