Individual
DR. RONALD OTTO NOWACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
16410 3RD ST, STE A, LA PINE, OR 97739
(541) 536-3693
(541) 636-9448
Mailing address
PO BOX 740, LA PINE, OR 97739
(541) 536-3693
(541) 639-9448
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
272735
OR
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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