Organization
VANDERLOO CHIROPRACTIC LLC
Active
Other names
Flores Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE RICHARD VANDERLOO D.C. (CHIROPRACTOR / OWNER)
(971) 255-1922
Entity
Organization
Contact information
Practice address
2230 W BURNSIDE ST STE D, PORTLAND, OR 97210-3727
(971) 255-1922
(971) 250-2884
Mailing address
2230 W BURNSIDE ST STE D, PORTLAND, OR 97210-3727
(971) 255-1922
(971) 250-2884
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5567
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8913150
MEDICARE PTAN
OR
Enumeration date
02/03/2015
Last updated
02/03/2015
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