Provider Demographics
NPI:1104018043
Name:ONTARIO CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:ONTARIO CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BJORNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-889-7797
Mailing Address - Street 1:200 SW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-2718
Mailing Address - Country:US
Mailing Address - Phone:541-889-7797
Mailing Address - Fax:541-889-3835
Practice Address - Street 1:200 SW 2ND AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-2718
Practice Address - Country:US
Practice Address - Phone:541-889-7797
Practice Address - Fax:541-889-3835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR025488003OtherBLUE CROSS