Provider Demographics
NPI:1336513134
Name:JAMES CHIROPRACTIC SPINE AND JOINT CENTER LLC
Entity Type:Organization
Organization Name:JAMES CHIROPRACTIC SPINE AND JOINT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LEVI
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-454-6176
Mailing Address - Street 1:2911 MARINE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-2836
Mailing Address - Country:US
Mailing Address - Phone:503-454-6176
Mailing Address - Fax:503-431-2358
Practice Address - Street 1:2911 MARINE DR
Practice Address - Street 2:SUITE C
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-2836
Practice Address - Country:US
Practice Address - Phone:503-454-6176
Practice Address - Fax:503-431-2358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5492111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty