Organization
EMBODIED CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY MARZIAZ D.C. (OWNER/CHIROPRACTOR)
(971) 271-2459
Entity
Organization
Contact information
Practice address
1715 E BURNSIDE ST, PORTLAND, OR 97214-1531
(971) 271-2459
Mailing address
1304 NE 73RD AVE, PORTLAND, OR 97213-6113
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
5638
OR
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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