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Individual

DR. RUSSELL A COLGAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1797 LANSING AVE NE, SALEM, OR 97303-1632
(503) 364-5751
(503) 364-4357
Mailing address
1797 LANSING AVE NE, SALEM, OR 97303-1632
(503) 364-5751
(503) 364-4357

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
65 1141
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
025916
OR
Enumeration date
05/11/2006
Last updated
07/08/2007
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