Provider Demographics
NPI:1932398948
Name:HEALING TOUCH CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:HEALING TOUCH CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZOHRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAMPBELL BOLDUC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-371-1120
Mailing Address - Street 1:3276 COMMERCIAL ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4584
Mailing Address - Country:US
Mailing Address - Phone:503-371-1120
Mailing Address - Fax:503-391-7422
Practice Address - Street 1:3276 COMMERCIAL ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4584
Practice Address - Country:US
Practice Address - Phone:503-371-1120
Practice Address - Fax:503-391-7422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272805111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR142694Medicare PIN