Healthcare Provider Details

I. General information

NPI: 1891829370
Provider Name (Legal Business Name): SOUTHERN OREGON CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2931 DOCTORS PARK DR
MEDFORD OR
97504-8127
US

IV. Provider business mailing address

1744 E MCANDREW RD SUITE D.
MEDFORD OR
97504
US

V. Phone/Fax

Practice location:
  • Phone: 541-245-4444
  • Fax: 541-200-2269
Mailing address:
  • Phone: 541-245-4444
  • Fax: 541-245-4443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number273544
License Number StateOR

VIII. Authorized Official

Name: DR. ERIC STEVEN REED
Title or Position: OWNER
Credential: D.C,
Phone: 541-414-0362