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General NPI Number Information
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NPI Number | 1164736393
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Entity Type | Organization
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Legal Business Name | VERTEBRATA CHIROPRACTIC, PC
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 07/29/2010
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Provider Practice Location Address
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Address Line | 107 SW 2ND ST
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City | CORVALLIS
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State | OR
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Zip | 97333-4715
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Country | US
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Telephone | 541-363-3100
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Fax | 866-572-0412
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Provider Business Mailing Address
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Address Line | 107 SW 2ND ST
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City | CORVALLIS
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State | OR
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Zip | 97333-4715
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Country | US
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Telephone | 541-363-3100
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Fax | 866-572-0412
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. WILLIAM JOSEPH O'DONNELL JR.
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Credential | D.C.
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Telephone | 541-363-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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