Provider Demographics
NPI:1114387974
Name:RECOVERY CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:RECOVERY CHIROPRACTIC INC.
Other - Org Name:REBOUND CHIROPRACTIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SINGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-656-1680
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-0008
Mailing Address - Country:US
Mailing Address - Phone:503-656-1680
Mailing Address - Fax:
Practice Address - Street 1:15480 SE 82ND DR
Practice Address - Street 2:STE B
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9633
Practice Address - Country:US
Practice Address - Phone:503-656-1680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty