Healthcare Provider Details

I. General information

NPI: 1780988261
Provider Name (Legal Business Name): AXIS HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2010
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 SW 5TH ST STE B
GRANTS PASS OR
97526-2509
US

IV. Provider business mailing address

333 SW 5TH ST STE B
GRANTS PASS OR
97526-2509
US

V. Phone/Fax

Practice location:
  • Phone: 541-471-0397
  • Fax: 541-471-6459
Mailing address:
  • Phone: 541-471-0397
  • Fax: 541-471-6459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2821
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. SANDRA PUYANA MARTIN
Title or Position: OWNER
Credential: D.C.
Phone: 541-471-0397