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General NPI Number Information
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NPI Number | 1821459793
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Entity Type | Organization
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Legal Business Name | EMMERT CHIROPRACTIC COMPANY
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Dates
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Enumeration Date | 03/18/2016
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Last Update Date | 07/29/2016
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Provider Practice Location Address
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Address Line | 1830 BLANKENSHIP RD STE 210
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City | WEST LINN
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State | OR
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Zip | 97068-4179
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Country | US
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Telephone | 503-557-1122
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Fax | 503-557-1119
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Provider Business Mailing Address
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Address Line | 1830 BLANKENSHIP RD STE 210
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City | WEST LINN
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State | OR
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Zip | 97068-4179
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Country | US
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Telephone | 503-557-1122
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Fax | 503-557-1119
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. SHERRY DEXHEIMER
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Credential |
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Telephone | 503-557-1122
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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 | 5111
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License Number State | OR
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