Healthcare Provider Details
I. General information
NPI: 1710651500
Provider Name (Legal Business Name): VALLEY CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/04/2021
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
318 E MAIN ST
MOLALLA OR
97038-9146
US
IV. Provider business mailing address
PO BOX 684
MOLALLA OR
97038-0684
US
V. Phone/Fax
- Phone: 503-829-2662
- Fax:
- Phone: 503-829-2662
- Fax: 503-829-2663
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAMELA
KRAEMER
Title or Position: OWNER
Credential: DC
Phone: 509-366-7075