Provider Demographics
NPI:1619107695
Name:COMPLETE CARE CHIROPRACTIC AND MASSAGE
Entity Type:Organization
Organization Name:COMPLETE CARE CHIROPRACTIC AND MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-773-9772
Mailing Address - Street 1:1296 S SHASTA AVE
Mailing Address - Street 2:
Mailing Address - City:EAGLE POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97524-8521
Mailing Address - Country:US
Mailing Address - Phone:541-830-4325
Mailing Address - Fax:541-826-2620
Practice Address - Street 1:1296 S SHASTA AVE
Practice Address - Street 2:
Practice Address - City:EAGLE POINT
Practice Address - State:OR
Practice Address - Zip Code:97524-8521
Practice Address - Country:US
Practice Address - Phone:541-830-4325
Practice Address - Fax:541-826-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3687261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR136687OtherMEDICARE PTAN
OR247322Medicaid