Organization
INJURY AND TRAUMA CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VOLODYMYR GOLOVAN (MANAGER)
(971) 254-8909
Entity
Organization
Contact information
Practice address
12774 SE STARK ST, PORTLAND, OR 97233-1539
(971) 254-8909
(971) 347-3104
Mailing address
12774 SE STARK ST, PORTLAND, OR 97233-1539
(971) 254-8909
(971) 347-3104
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
12/06/2020
Last updated
12/06/2020
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