Organization
WELLSPRING CHIROPRACTIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN LEE MCCAUSLAND D.C. (PRESIDENT)
(503) 397-2202
Entity
Organization
Contact information
Practice address
165 N 11TH ST, SAINT HELENS, OR 97051-1803
(503) 397-2202
(503) 397-7113
Mailing address
165 N 11TH ST, SAINT HELENS, OR 97051-1803
(503) 397-2202
(503) 397-7113
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2864
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R102662
MEDICARE (UNSURE IWHAT OPTION ABOVE APPLIES)
OR
Enumeration date
08/31/2010
Last updated
08/31/2010
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