Renovo Chiropractic Llc | |
2147 Nw Highway 101 Lincoln City OR 97367-4254 | |
(541) 961-8116 | |
Not Available |
Full Name | Renovo Chiropractic Llc |
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Speciality | Clinic/Center |
Location | 2147 Nw Highway 101, Lincoln City, Oregon |
Authorized Official Name and Position | Michael Angel Nelson (OWNER) |
Authorized Official Contact | 5419618116 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Renovo Chiropractic Llc Po Box 1235 Lincoln City OR 97367-8135 Ph: (541) 961-8116 | Renovo Chiropractic Llc 2147 Nw Highway 101 Lincoln City OR 97367-4254 Ph: (541) 961-8116 |
NPI Number | 1710442751 |
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Provider Enumeration Date | 02/04/2019 |
Last Update Date | 04/29/2019 |
Medicare PECOS PAC ID | 9436491156 |
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Medicare Enrollment ID | O20190430000840 |
Identifier | Type | State | Issuer |
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1710442751 | NPI | - | NPPES |
50073474 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Michael Angel Nelson |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1275060410 PECOS PAC ID: 9931478856 Enrollment ID: I20170710001662 |
Provider Name | Mark M Gabriel |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1538457585 PECOS PAC ID: 2668742065 Enrollment ID: I20170719001331 |
Provider Name | Olga Tsytsyna |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558833301 PECOS PAC ID: 5193112100 Enrollment ID: I20220520000116 |
Samaritan North Lincoln Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 Ne 28th St, Lincoln City, OR 97367 Phone: 541-768-7900 | |