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Organization

CENTRAL OREGON CHIROPRACTIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENT ROOKSTOOL DC (OWNER)
(541) 923-6024
Entity
Organization

Contact information

Practice address
1020 SW INDIAN AVE STE 102, REDMOND, OR 97756-3037
(541) 923-6024
(541) 699-4287
Mailing address
1020 SW INDIAN AVE STE 102, REDMOND, OR 97756-3037
(541) 923-6024
(541) 699-4287

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
5131
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1063753861
PERSONAL NPI
OR
Enumeration date
08/21/2015
Last updated
03/21/2016
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