Provider Demographics
NPI:1407154214
Name:CENTER FOR CHINESE MEDICINE, PC
Entity Type:Organization
Organization Name:CENTER FOR CHINESE MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BENDAT
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:541-482-7071
Mailing Address - Street 1:180 CLEAR CREEK DR STE 104
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1993
Mailing Address - Country:US
Mailing Address - Phone:541-482-7071
Mailing Address - Fax:541-482-6826
Practice Address - Street 1:180 CLEAR CREEK DR STE 104
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1993
Practice Address - Country:US
Practice Address - Phone:541-482-7071
Practice Address - Fax:541-482-6826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR150171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty