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General NPI Number Information
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NPI Number | 1295274520
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Entity Type | Organization
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Legal Business Name | PURE LIGHT FAMILY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 155 SW CENTURY DR BEND PILATES
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City | BEND
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State | OR
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Zip | 97702-1657
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Country | US
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Telephone | 781-820-6816
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Fax |
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Provider Business Mailing Address
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Address Line | 61561 AARON WAY #6303
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City | BEND
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State | OR
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Zip | 97702-8804
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Country | US
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Telephone | 781-820-6816
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR, OWNER, MEMBER
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Name | DR. SARAH ELIZABETH POWERS
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Credential | D.C.
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Telephone | 458-202-4303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 5802
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License Number State | OR
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