Healthcare Provider Details

I. General information

NPI: 1346327095
Provider Name (Legal Business Name): CHARLES SCOTT SALMONS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 NORTH HIGHWAY 101 SUITE J
DEPOE BAY OR
97341-0750
US

IV. Provider business mailing address

PO BOX 750 531 N. HIGHWAY 101 STE. J
DEPOE BAY OR
97341-0750
US

V. Phone/Fax

Practice location:
  • Phone: 541-765-3200
  • Fax:
Mailing address:
  • Phone: 541-765-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberOR2740
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: