Provider Demographics
NPI:1609939172
Name:WEBB, RONNY ODELL (DC)
Entity Type:Individual
Prefix:DR
First Name:RONNY
Middle Name:ODELL
Last Name:WEBB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16857 ARNEY RD NE
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:OR
Mailing Address - Zip Code:97071-9407
Mailing Address - Country:US
Mailing Address - Phone:503-981-1479
Mailing Address - Fax:503-981-0260
Practice Address - Street 1:1585 N PACIFIC HWY
Practice Address - Street 2:SUITE T
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-3656
Practice Address - Country:US
Practice Address - Phone:503-981-1267
Practice Address - Fax:503-981-0260
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27-1500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORQGBVNMedicare ID - Type Unspecified