| Samaritan Chiropractic Llc | |
|
634 Nw 4th St Corvallis OR 97330-6413 | |
| (541) 752-0776 | |
| Not Available |
| Full Name | Samaritan Chiropractic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 634 Nw 4th St, Corvallis, Oregon |
| Authorized Official Name and Position | Edward Elgin Koen (CHEIF OFFICER) |
| Authorized Official Contact | 5417520776 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samaritan Chiropractic Llc 634 Nw 4th St Corvallis OR 97330-6413 Ph: (541) 752-0776 | Samaritan Chiropractic Llc 634 Nw 4th St Corvallis OR 97330-6413 Ph: (541) 752-0776 |
| NPI Number | 1700148251 |
|---|---|
| Provider Enumeration Date | 06/11/2012 |
| Last Update Date | 06/11/2012 |
| Medicare PECOS PAC ID | 2264686849 |
|---|---|
| Medicare Enrollment ID | O20130207000006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700148251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 3838 (Oregon) | Primary |
| Provider Name | Edward Elgin Koen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1992960322 PECOS PAC ID: 4082868666 Enrollment ID: I20130207000009 |
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