Healthcare Provider Details

I. General information

NPI: 1821610155
Provider Name (Legal Business Name): ACCIDENT CARE CHIROPRACTIC AND MASSAGE OF KEIZER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2020
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5167 RIVER RD N
KEIZER OR
97303-5349
US

IV. Provider business mailing address

5167 RIVER RD N
KEIZER OR
97303-5349
US

V. Phone/Fax

Practice location:
  • Phone: 503-990-7054
  • Fax: 503-479-0081
Mailing address:
  • Phone: 503-990-7054
  • Fax: 503-479-0081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD SCOTT SEDEI
Title or Position: PARTNER/PHYSICIAN
Credential: DC, MS
Phone: 503-990-7054