Provider Demographics
NPI:1679757041
Name:PORTER CHIROPRACTIC RESEARCH INSTITUTE, LTD.
Entity Type:Organization
Organization Name:PORTER CHIROPRACTIC RESEARCH INSTITUTE, LTD.
Other - Org Name:PORTERWELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-331-0177
Mailing Address - Street 1:PO BOX 20788
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89515-0788
Mailing Address - Country:US
Mailing Address - Phone:775-331-0177
Mailing Address - Fax:775-331-8391
Practice Address - Street 1:1005 TERMINAL WY
Practice Address - Street 2:STE 270
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-331-0177
Practice Address - Fax:775-331-8391
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PORTER CHIROPRACTIC RESEARCH INSTITUTE, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-20
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB115111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty