Organization
MDC CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDDY MYDOUANGCHANH DC (OWNER)
(503) 249-0114
Entity
Organization
Contact information
Practice address
4410 NE FREMONT ST., PORTLAND, OR 97213
(503) 249-0114
(503) 214-8175
Mailing address
4410 NE FREMONT ST., PORTLAND, OR 97213-1154
(503) 249-0114
(503) 214-8175
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4452
OR
Other
Enumeration date
07/30/2014
Last updated
08/07/2018
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