Provider Demographics
NPI:1073796876
Name:CHIROPRACTIC FAMILY HEALTH CENTER
Entity Type:Organization
Organization Name:CHIROPRACTIC FAMILY HEALTH CENTER
Other - Org Name:LAWTON CHIROPRACTIC CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-581-7590
Mailing Address - Street 1:2250 COMMERCIAL ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-0716
Mailing Address - Country:US
Mailing Address - Phone:503-581-7590
Mailing Address - Fax:503-581-6641
Practice Address - Street 1:2250 COMMERCIAL ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-0716
Practice Address - Country:US
Practice Address - Phone:503-581-7590
Practice Address - Fax:503-581-6641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty