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General NPI Number Information
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NPI Number | 1679757041
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Entity Type | Organization
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Legal Business Name | PORTER CHIROPRACTIC RESEARCH INSTITUTE, LTD.
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 09/26/2018
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Provider Practice Location Address
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Address Line | 1005 TERMINAL WY STE 270
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City | RENO
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State | NV
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Zip | 89502
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Country | US
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Telephone | 775-331-0177
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Fax | 775-331-8391
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Provider Business Mailing Address
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Address Line | PO BOX 20788
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City | RENO
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State | NV
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Zip | 89515-0788
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Country | US
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Telephone | 775-331-0177
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Fax | 775-331-8391
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Authorized Official
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Title or Position | OWNER
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Name | CLYDE WILLIAM PORTER
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Credential |
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Telephone | 775-331-0177
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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 | B115
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License Number State | NV
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