Healthcare Provider Details
I. General information
NPI: 1346410800
Provider Name (Legal Business Name): ALLEN KNECHT, DC, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/11/2008
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5331 SW MACADAM AVENUE SUITE 307
PORTLAND OR
97239-3859
US
IV. Provider business mailing address
5331 SW MACADAM AVENUE SUITE 307
PORTLAND OR
97239-3859
US
V. Phone/Fax
- Phone: 503-226-8010
- Fax: 503-210-0338
- Phone: 503-226-8010
- Fax: 503-210-0338
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 272969 |
| License Number State | OR |
VIII. Authorized Official
Name: DR.
ALLEN
G
KNECHT
Title or Position: OWNER
Credential: D.C.
Phone: 503-226-8010