Organization
FULCRUM OSTEOPATHIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW PATRICK EVITTS DO (OWNER/MEMBER)
(541) 250-5994
Entity
Organization
Contact information
Practice address
525 NW 2ND ST, CORVALLIS, OR 97330-6487
(541) 250-5994
(541) 638-4002
Mailing address
525 NW 2ND ST, CORVALLIS, OR 97330-6487
(541) 250-5994
(541) 638-4002
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287713
—
OR
Enumeration date
05/23/2022
Last updated
12/29/2023
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