# COOS BAY CHIROPRACTIC & WELLNESS CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coos Bay Chiropractic and Wellness Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518115781
- **Authorized official:** DR. RICK CHARLES WHITE M.D. (OWNER)
- **Authorized official phone:** (541) 808-9285

## Contact information

- **Practice address:** 1611 VIRGINIA AVE, STE 117, NORTH BEND, OR 97459-2729
- **Practice address phone:** (541) 808-9285
- **Practice address fax:** (541) 808-9287
- **Mailing address:** 1611 VIRGINIA AVE, BOX 414, NORTH BEND, OR 97459-2729
- **Mailing address phone:** (541) 808-9285
- **Mailing address fax:** (541) 808-9287

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 3170 | OR | Yes |

## Other

- **Enumeration date:** 08/29/2008
- **Last updated:** 08/09/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1174699680 | NPI | OR |