Individual
DR. VIP B SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1448 E 22ND AVE, EUGENE, OR 97403-1703
(541) 342-4476
(541) 343-4359
Mailing address
1448 E 22ND AVE, EUGENE, OR 97403-1703
(541) 342-4476
(541) 343-4359
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
271747
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R117075
MEDICARE PTAN/LEGACY NUMB
OR
Enumeration date
03/19/2008
Last updated
03/19/2008
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