Organization
WHITAKER WELLNESS LLC
Active
Other names
Powell Valley Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ROBERT WHITAKER D.C. (MEMBER)
(503) 661-5090
Entity
Organization
Contact information
Practice address
4253 SE 182ND AVE, GRESHAM, OR 97030-5083
(503) 661-5090
Mailing address
4253 SE 182ND AVE, GRESHAM, OR 97030-5083
(503) 661-5090
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
5545
OR
Other
Enumeration date
10/28/2016
Last updated
10/28/2016
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