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General NPI Number Information
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NPI Number | 1730239468
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Entity Type | Organization
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Legal Business Name | CEDAR HILLS CHIROPRACTICS
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4270 SW CEDAR HILLS BLVD
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City | BEAVERTON
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State | OR
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Zip | 97005-2029
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Country | US
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Telephone | 503-526-3880
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Fax | 503-526-3387
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Provider Business Mailing Address
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Address Line | 4270 SW CEDAR HILLS BLVD
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City | BEAVERTON
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State | OR
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Zip | 97005-2029
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Country | US
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Telephone | 503-526-3880
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Fax | 503-526-3387
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MR. GLEN INGRAM BERRY
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Credential | DC
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Telephone | 503-526-3880
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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 | 651486
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License Number State | OR
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