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Organization
PERFORMANCE AND SPINE CHIROPRACTIC CENTER, LLC
Active
Organization
PERFORMANCE AND SPINE CHIROPRACTIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN KINNEY (MEMBER)
(503) 348-4464
Entity
Organization
Contact information
Practice address
19365 SW 65TH AVE, SUITE 104, TUALATIN, OR 97062-9196
(503) 348-4464
Mailing address
19365 SW 65TH AVE, SUITE 104, TUALATIN, OR 97062-9196
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3859
OR
Other
Enumeration date
07/09/2008
Last updated
07/09/2008
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