Healthcare Provider Details

I. General information

NPI: 1295844116
Provider Name (Legal Business Name): NEWBERG FAMILY CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 E HANCOCK ST
NEWBERG OR
97132-2822
US

IV. Provider business mailing address

114 E HANCOCK ST
NEWBERG OR
97132-2822
US

V. Phone/Fax

Practice location:
  • Phone: 503-554-0661
  • Fax: 503-554-9126
Mailing address:
  • Phone: 503-554-0661
  • Fax: 503-554-9126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number27-3356
License Number StateOR

VIII. Authorized Official

Name: DR. JULIE E MOCK
Title or Position: OWNER
Credential: D.C.
Phone: 503-554-0661