Healthcare Provider Details

I. General information

NPI: 1912255308
Provider Name (Legal Business Name): HEPPNER CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2012
Last Update Date: 08/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 COMMERCIAL ST SE STE 260
SALEM OR
97302-4288
US

IV. Provider business mailing address

925 COMMERCIAL ST SE STE 260
SALEM OR
97302-4288
US

V. Phone/Fax

Practice location:
  • Phone: 503-391-9222
  • Fax: 503-363-8193
Mailing address:
  • Phone: 503-391-9222
  • Fax: 503-363-8193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number4850
License Number StateOR

VIII. Authorized Official

Name: DR. ABBY HEPPNER
Title or Position: OWNER
Credential: DC
Phone: 503-391-9222