Provider Demographics
NPI:1225173693
Name:KEHR CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:KEHR CHIROPRACTIC, INC
Other - Org Name:BLUE MOUNTAIN CHIROPRACTIC CLINIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BENEDICTE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-963-9632
Mailing Address - Street 1:2008 3RD ST STE B
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-2200
Mailing Address - Country:US
Mailing Address - Phone:541-963-9632
Mailing Address - Fax:541-963-6346
Practice Address - Street 1:2008 3RD ST STE B
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-2200
Practice Address - Country:US
Practice Address - Phone:541-963-9632
Practice Address - Fax:541-963-6346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1228111N00000X
OR3322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR102269Medicaid
OR028509Medicaid
OR69558Medicare UPIN
ORR112258Medicare PIN
ORR112257Medicare PIN
ORDD8696Medicare PIN
ORT67776Medicare UPIN
OR102269Medicaid
ORR112256Medicare PIN