Provider Demographics
NPI:1508238676
Name:NEXT LEVEL CHIROPRACTIC OF WILSONVILLE
Entity Type:Organization
Organization Name:NEXT LEVEL CHIROPRACTIC OF WILSONVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-625-7755
Mailing Address - Street 1:29970 SW TOWN CENTER LOOP W
Mailing Address - Street 2:STE C
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-7429
Mailing Address - Country:US
Mailing Address - Phone:503-625-7755
Mailing Address - Fax:
Practice Address - Street 1:29970 SW TOWN CENTER LOOP W
Practice Address - Street 2:STE C
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-7429
Practice Address - Country:US
Practice Address - Phone:503-625-7755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5043111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty