| NPI | 1942329982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH WAYNE BOLINE Chiropractic Physician 503-393-0321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 27 1775) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |