Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH00001073 | WA |
NPI | 1003884131 |
---|---|
Provider Name | Peter Thomas Zografos |
First Address | Spokane Valley, WA 99212-2705 |
Second Address | Spokane Valley, WA 99212-2705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 19/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T02417 | (02) | WA |