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General NPI Number Information
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NPI Number | 1013438829
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Entity Type | Organization
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Legal Business Name | OREGON SPORTS AND FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 434 VILLA RD
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City | NEWBERG
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State | OR
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Zip | 97132-1855
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Country | US
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Telephone | 503-554-0022
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Fax | 503-554-0033
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Provider Business Mailing Address
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Address Line | 434 VILLA RD
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City | NEWBERG
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State | OR
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Zip | 97132-1855
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Country | US
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Telephone | 503-554-0022
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Fax | 503-554-0033
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. JOHN BRANDEN GARLAND
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Credential | D.C., C.C.S.P.
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Telephone | 503-554-0022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 5042
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License Number State | OR
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