Provider Demographics
NPI:1154449890
Name:FALLING WATERS LLC
Entity Type:Organization
Organization Name:FALLING WATERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLINTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-389-4321
Mailing Address - Street 1:55 NW WALL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-3200
Mailing Address - Country:US
Mailing Address - Phone:541-389-4321
Mailing Address - Fax:541-389-4420
Practice Address - Street 1:55 NW WALL ST STE 100
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-3200
Practice Address - Country:US
Practice Address - Phone:541-389-4321
Practice Address - Fax:541-389-4420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1740204981OtherDR. DAVIES NPI#