Organization
INTEGRATIVE WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD BRAD MCCONNELL LAC (LICENSED ACUPUNTURIST)
(503) 997-7181
Entity
Organization
Contact information
Practice address
2343 SE 44TH AVE, PORTLAND, OR 97215-3721
(503) 997-7181
Mailing address
2343 SE 44TH AVE, PORTLAND, OR 97215-3721
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
AC00850
OR
Other
Enumeration date
05/31/2008
Last updated
05/31/2008
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