| NPI | 1194069450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA R WOLFRAM Owner 503-689-1216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 3989) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 13553) |
| 225700000X Massage Therapist (Licence: OR 17108) | |
| 225700000X Massage Therapist (Licence: OR 14327) | |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |