Provider Demographics
NPI:1821630765
Name:SISKIYOU CHIROPRACTIC & MASSAGE
Entity Type:Organization
Organization Name:SISKIYOU CHIROPRACTIC & MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-414-0362
Mailing Address - Street 1:1744 E MCANDREWS RD STE D
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5576
Mailing Address - Country:US
Mailing Address - Phone:541-414-0362
Mailing Address - Fax:541-200-2269
Practice Address - Street 1:700 S MAIN ST
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-3354
Practice Address - Country:US
Practice Address - Phone:541-414-0362
Practice Address - Fax:541-200-2269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-11
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty