Provider Demographics
NPI:1790259653
Name:ASPEN CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:ASPEN CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RENEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-672-4807
Mailing Address - Street 1:535 NE STEPHENS ST
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-3150
Mailing Address - Country:US
Mailing Address - Phone:541-672-4807
Mailing Address - Fax:
Practice Address - Street 1:2569 NW EDENBOWER BLVD
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-6220
Practice Address - Country:US
Practice Address - Phone:541-672-4807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPEN CHIROPRACTIC P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-14
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty