Provider Demographics
NPI:1508079971
Name:PORTERFIELD & DON CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:PORTERFIELD & DON CHIROPRACTIC, INC
Other - Org Name:FOUNDATION FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:DON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:909-948-9661
Mailing Address - Street 1:8225 WHITE OAK AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7671
Mailing Address - Country:US
Mailing Address - Phone:909-948-9661
Mailing Address - Fax:909-948-9691
Practice Address - Street 1:8225 WHITE OAK AVE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7671
Practice Address - Country:US
Practice Address - Phone:909-948-9661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2012-12-05
Deactivation Date:2008-06-04
Deactivation Code:
Reactivation Date:2008-08-21
Provider Licenses
StateLicense IDTaxonomies
CADC-0271530111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty