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Organization

ASPEN INJURY CENTER LLC

Active
Other names
Aspen Chiropractic Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD RENEUA DC (OWNER)
(541) 767-3788
Entity
Organization

Contact information

Practice address
1260 E MAIN ST, COTTAGE GROVE, OR 97424-2217
(541) 767-3788
(541) 946-1057
Mailing address
1260 E MAIN ST, COTTAGE GROVE, OR 97424-2217
(541) 767-3788
(541) 946-1057

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5112
CHIROPRACTIC
OR
Enumeration date
01/14/2019
Last updated
01/14/2019
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