Healthcare Provider Details

I. General information

NPI: 1750212338
Provider Name (Legal Business Name): VICTORY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 NW BOND ST
BEND OR
97703-3306
US

IV. Provider business mailing address

328 NW BOND ST
BEND OR
97703-3306
US

V. Phone/Fax

Practice location:
  • Phone: 505-412-1379
  • Fax:
Mailing address:
  • Phone: 505-412-1379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. COLTON POPE
Title or Position: OWNER
Credential: POPE
Phone: 505-412-1379