| NPI | 1104221530 |
|---|---|
| Doing Business As | ACTIVE FAMILY CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | MICHELLE K WAGGONER President 503-674-7894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: OR 3666) |
| Additional Taxonomies | 111NP0017X Chiropractor Pediatric Chiropractor (Licence: OR 3725) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-28 |