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General NPI Number Information
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NPI Number | 1164768818
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Entity Type | Organization
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Legal Business Name | TV HIGHWAY CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 12/28/2012
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 18055 SW TV HWY
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City | ALOHA
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State | OR
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Zip | 97006-3953
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Country | US
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Telephone | 503-642-3018
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Fax |
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Provider Business Mailing Address
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Address Line | 18055 SW TV HWY
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City | ALOHA
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State | OR
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Zip | 97006-3953
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Country | US
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Telephone | 503-642-3018
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. DUY N BUI
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Credential | D.C.
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Telephone | 503-642-6018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 4091
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4091
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License Number State | OR
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