Organization
MARK DIAZ D.C. P.C.
Active
Other names
Ash Creek Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK JEFFERY DIAZ D.C. (PRESIDENT)
(503) 838-1951
Entity
Organization
Contact information
Practice address
226 S MAIN ST, STE C, INDEPENDENCE, OR 97351-2070
(503) 838-1951
(503) 606-2087
Mailing address
226 S MAIN ST, STE C, INDEPENDENCE, OR 97351-2070
(503) 838-1951
(503) 606-2087
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3816
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245405893
INDIVIDUAL NPI
—
Enumeration date
07/29/2011
Last updated
07/29/2011
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