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General NPI Number Information
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NPI Number | 1801109988
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Entity Type | Organization
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Legal Business Name | SYMTRIO CHIROPRACTIC CLINIC, INC.
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 6125 NE CORNELL RD STE 300
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City | HILLSBORO
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State | OR
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Zip | 97124-5417
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Country | US
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Telephone | 503-924-1777
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Fax | 503-924-2778
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Provider Business Mailing Address
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Address Line | 6125 NE CORNELL RD STE 300
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City | HILLSBORO
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State | OR
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Zip | 97124-5417
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Country | US
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Telephone | 503-924-1777
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Fax | 503-924-2778
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL KRUEGER
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Credential | DC
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Telephone | 503-924-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 3699
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License Number State | OR
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