Provider Demographics
NPI:1609436104
Name:POPE, COLTON H
Entity Type:Individual
Prefix:DR
First Name:COLTON
Middle Name:H
Last Name:POPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 NW FRANKLIN AVE
Mailing Address - Street 2:UNIT #2
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-2882
Mailing Address - Country:US
Mailing Address - Phone:541-318-8627
Mailing Address - Fax:
Practice Address - Street 1:225 NW FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2867
Practice Address - Country:US
Practice Address - Phone:541-318-8627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor