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General NPI Number Information
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NPI Number | 1952811408
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Entity Type | Organization
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Legal Business Name | PLASKER CHIROPRACTIC AND FUNCTIONAL NEUROLOGY LLC
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 01/17/2018
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Provider Practice Location Address
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Address Line | 155 SW CENTURY DR STE 104
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City | BEND
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State | OR
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Zip | 97702-1657
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Country | US
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Telephone | 458-206-3461
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Fax | 458-206-3461
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Provider Business Mailing Address
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Address Line | 61557 AARON WAY APT 3301
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City | BEND
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State | OR
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Zip | 97702-8803
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Country | US
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Telephone | 404-909-5764
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | JACOB PLASKER
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Credential | DC
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Telephone | 404-909-5764
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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 | 5745
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License Number State | OR
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