| NPI | 1942557715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN EDWARD BODTKER Owner 503-924-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2012-08-10 |