Organization
GUSTAV E SCHEFSTROM
Active
Other names
Rogue Valley Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUSTAV E SCHEFSTROM D.C. B.C.A.O. (CHIROPRACTIC PHYSICIAN)
(541) 779-8338
Entity
Organization
Contact information
Practice address
1744 E MCANDREWS RD, SUITE A, MEDFORD, OR 97504-5576
(541) 779-8338
(541) 858-0749
Mailing address
1744 E MCANDREWS RD, SUITE A, MEDFORD, OR 97504-5576
(541) 779-8338
(541) 858-0749
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27 1902
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350008024
RR MEDICARE
OR
01
—
R112380
MEDICARE GRP
OR
01
—
R112382
MEDICARE PROVIDER
OR
Enumeration date
12/06/2007
Last updated
06/10/2011
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