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Organization
CRATER CHIROPRACTIC CLINIC PC
Active
Organization
CRATER CHIROPRACTIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L WARREN DC (PRESIDENT)
(541) 734-7333
Entity
Organization
Contact information
Practice address
3560 NATIONAL RD, SUITE 100, MEDFORD, OR 97504-4008
(541) 734-7333
(541) 734-8802
Mailing address
3560 NATIONAL RD, SUITE 100, MEDFORD, OR 97504-4008
(541) 734-7333
(541) 734-8802
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
272888
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710930151
NPI GROUP
OR
01
—
1790811511
NPI INDIVIDUAL
OR
Enumeration date
05/18/2006
Last updated
10/15/2007
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