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Organization
MARK DIAZ D.C. P.C.
Active
Organization
MARK DIAZ D.C. P.C.
Active
Other names
Ash Creek Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK JEFFERY DIAZ D.C. (PRESIDENT)
(503) 838-1951
Entity
Organization
Contact information
Practice address
226 S MAIN ST, STE C, INDEPENDENCE, OR 97351-2070
(503) 838-1951
(503) 606-2087
Mailing address
226 S MAIN ST, STE C, INDEPENDENCE, OR 97351-2070
(503) 838-1951
(503) 606-2087
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3816
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245405893
INDIVIDUAL NPI
—
Enumeration date
07/29/2011
Last updated
07/29/2011
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