Organization
RENOVO CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ANGEL NELSON DC (OWNER)
(541) 961-8116
Entity
Organization
Contact information
Practice address
2147 NW HIGHWAY 101, LINCOLN CITY, OR 97367-4254
(541) 961-8116
Mailing address
PO BOX 1235, LINCOLN CITY, OR 97367-8135
(541) 961-8116
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50073474
—
OR
Enumeration date
02/04/2019
Last updated
04/29/2019
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