| Tietsort Chiropractic Clinic | |
|
28 North Keller Street, Republic, WA 99166-0577 | |
| (509) 775-3321 | |
| (509) 775-3320 |
| Full Name | Tietsort Chiropractic Clinic |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 28 North Keller Street, Republic, Washington |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609179217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CH00001288 (Washington) | Primary |
| Provider Name | Steven G Tietsort |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1629108436 PECOS PAC ID: 8123207818 Enrollment ID: I20110127000202 |
| Mailing Address | Practice Location Address |
|---|---|
| Tietsort Chiropractic Clinic P.o. 577, Republic, WA 99166-0577 Ph: (509) 775-3321 | Tietsort Chiropractic Clinic 28 North Keller Street, Republic, WA 99166-0577 Ph: (509) 775-3321 |
Intelligent Balance Chiropractic Spinal Care, Pllc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 56 N Clark Ave, Unit 1, Republic, WA 99166 Phone: 509-775-2553 Fax: 509-924-1249 | |
Dr. Steven George Tietsort, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 28 N Keller Street, Republic, WA 99166 Phone: 509-775-3321 Fax: 509-775-3320 |