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General NPI Number Information
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NPI Number | 1205175999
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Entity Type | Organization
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Legal Business Name | DOCTORS CHOICE PAIN MANAGEMENT LLC
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Dates
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Enumeration Date | 01/31/2013
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 1880 LANCASTER DR NE SUITE 101-102
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City | SALEM
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State | OR
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Zip | 97305-1089
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Country | US
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Telephone | 503-362-1002
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Fax | 503-362-1006
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Provider Business Mailing Address
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Address Line | 1880 LANCASTER DR NE SUITE 101-102
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City | SALEM
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State | OR
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Zip | 97305-1089
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Country | US
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Telephone | 503-362-1002
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Fax | 503-362-1006
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Authorized Official
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Title or Position | MANGER
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Name | DESIREE WHITMIRE
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Credential |
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Telephone | 503-362-1006
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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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