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Organization

SCSM, INC

Active
Other names
Eastside Spine & Injury
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN BLAKE SIMS DC (PRESIDENT)
(503) 654-7400
Entity
Organization

Contact information

Practice address
4370 SE KING RD STE 220, MILWAUKIE, OR 97222-1613
(503) 654-7400
(503) 654-1003
Mailing address
4370 SE KING RD STE 220, MILWAUKIE, OR 97222-1613
(503) 654-7400
(503) 654-1003

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3930
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500681331
OR
Enumeration date
07/17/2012
Last updated
12/16/2019
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