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General NPI Number Information
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NPI Number | 1184248726
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Entity Type | Organization
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Legal Business Name | CHIROCENTRIC, LLC
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Dates
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Enumeration Date | 05/29/2020
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 14355 SW ALLEN BLVD. SUITE 150
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City | BEAVERTON
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State | OR
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Zip | 97005-4741
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Country | US
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Telephone | 503-806-5700
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Fax | 877-940-4288
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Provider Business Mailing Address
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Address Line | 14355 SW ALLEN BLVD. SUITE 150
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City | BEAVERTON
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State | OR
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Zip | 97005-4741
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Country | US
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Telephone | 503-806-5700
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Fax | 877-940-4288
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | DR. KIMBERLY DE ALTO
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Credential | D.C.
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Telephone | 503-430-7371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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