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General NPI Number Information
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NPI Number | 1942181821
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Entity Type | Organization
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Legal Business Name | HEALTH REVOLUTION CHIROPRACTIC
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 193 MAIN ST
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City | YONCALLA
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State | OR
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Zip | 97499-9021
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Country | US
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Telephone | 541-849-2111
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Fax | 541-871-7080
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Provider Business Mailing Address
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Address Line | PO BOX 280
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City | YONCALLA
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State | OR
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Zip | 97499-0280
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Country | US
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Telephone | 541-849-2111
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Fax | 541-871-7080
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Authorized Official
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Title or Position | CORPORATE PRESIDENT / CHIROPRACTOR
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Name | GREGORY S BLANCHFILL
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Credential | DC
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Telephone | 541-849-2111
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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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