Provider Demographics
NPI:1831757475
Name:STRUCTURAL SOLUTIONS CHIROPRACTIC
Entity type:Organization
Organization Name:STRUCTURAL SOLUTIONS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VENCIL
Authorized Official - Middle Name:
Authorized Official - Last Name:OVERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-325-6674
Mailing Address - Street 1:3325 GILHAM RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7165
Mailing Address - Country:US
Mailing Address - Phone:541-325-6674
Mailing Address - Fax:
Practice Address - Street 1:121 NW EVERETT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-4049
Practice Address - Country:US
Practice Address - Phone:541-325-6674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR3731OtherOREGON CHIROPRACTIC BOARD