Healthcare Provider Details

I. General information

NPI: 1205833969
Provider Name (Legal Business Name): ALLEN MCCASLIN HUTCHESON D.C., L.M.T
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

977 ROYAL AVE
MEDFORD OR
97504-6140
US

IV. Provider business mailing address

977 ROYAL AVE
MEDFORD OR
97504-6140
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number5644
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3516
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: