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General NPI Number Information
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NPI Number | 1295844116
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Entity Type | Organization
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Legal Business Name | NEWBERG FAMILY CHIROPRACTIC PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 114 E HANCOCK ST
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City | NEWBERG
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State | OR
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Zip | 97132-2822
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Country | US
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Telephone | 503-554-0661
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Fax | 503-554-9126
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Provider Business Mailing Address
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Address Line | 114 E HANCOCK ST
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City | NEWBERG
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State | OR
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Zip | 97132-2822
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Country | US
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Telephone | 503-554-0661
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Fax | 503-554-9126
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Authorized Official
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Title or Position | OWNER
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Name | DR. JULIE E MOCK
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Credential | D.C.
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Telephone | 503-554-0661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 27-3356
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License Number State | OR
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