1982776522 NPI number — IMPROVEMENT CHIROPRACTIC & REHAB L.L.C.

Table of content: JOHN SAVIDAKIS JR. DPM (NPI 1750454740)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982776522 NPI number — IMPROVEMENT CHIROPRACTIC & REHAB L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IMPROVEMENT CHIROPRACTIC & REHAB L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982776522
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12413 NE STANTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97230-1649
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-254-8655
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21440 SE STARK ST # 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRESHAM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97030-2024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-489-2992
Provider Business Practice Location Address Fax Number:
503-489-2994
Provider Enumeration Date:
11/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NUTTALL
Authorized Official First Name:
JESSE
Authorized Official Middle Name:
LAYNE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
503-254-8655

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  273624 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com