| NPI | 1295912202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN ALLEN CLARK Owner 503-244-0920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: OR 1856) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |