Organization
PONDEROSA FAMILY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY L GREEN D.C. (CHIROPRACTOR, OWNER)
(541) 588-6200
Entity
Organization
Contact information
Practice address
1011 DESPERADO TRAIL, STE 202, SISTERS, OR 97759
(541) 588-6200
(541) 588-6201
Mailing address
PO BOX 747, SISTERS, OR 97759
(541) 588-6200
(541) 588-6201
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3756
OR
Other
Enumeration date
10/05/2009
Last updated
10/05/2009
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