Provider Demographics
NPI:1710651500
Name:VALLEY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:VALLEY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAEMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-366-7075
Mailing Address - Street 1:PO BOX 684
Mailing Address - Street 2:
Mailing Address - City:MOLALLA
Mailing Address - State:OR
Mailing Address - Zip Code:97038-0684
Mailing Address - Country:US
Mailing Address - Phone:503-829-2662
Mailing Address - Fax:503-829-2663
Practice Address - Street 1:207 S MOLALLA AVE
Practice Address - Street 2:
Practice Address - City:MOLALLA
Practice Address - State:OR
Practice Address - Zip Code:97038-9119
Practice Address - Country:US
Practice Address - Phone:503-829-2662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty