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General NPI Number Information
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NPI Number | 1457531097
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Entity Type | Organization
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Legal Business Name | WELLNESS WITHIN CHIROPRACTIC, INC
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 11/12/2007
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Provider Practice Location Address
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Address Line | 2263 NE CORNELL RD
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City | HILLSBORO
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State | OR
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Zip | 97124-5947
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Country | US
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Telephone | 503-640-3207
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Fax | 503-640-5315
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Provider Business Mailing Address
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Address Line | 2263 NE CORNELL RD
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City | HILLSBORO
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State | OR
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Zip | 97124-5947
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Country | US
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Telephone | 503-640-3207
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Fax | 503-640-5315
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANITA MARIE STEFAN
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Credential | D.C.
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Telephone | 503-640-3207
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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 | 273112
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License Number State | OR
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