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General NPI Number Information
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NPI Number | 1558179713
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Entity Type | Organization
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Legal Business Name | VALLEY FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 7742 SW NIMBUS AVE
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City | BEAVERTON
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State | OR
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Zip | 97008-6400
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Country | US
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Telephone | 971-243-1014
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Fax |
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Provider Business Mailing Address
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Address Line | 8496 SW JESSICA ST UNIT 1211
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City | WILSONVILLE
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State | OR
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Zip | 97070-8630
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Country | US
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Telephone | 831-747-4494
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | TONI KANDCER
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Credential | DC
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Telephone | 831-747-4494
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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 |
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License Number State |
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