Active Injury Rehab, LLC
Chiropractor in Portland, OR. Organization (NPI-2).
NPI number1003679200
StatusActive
Last updated in NPPESFeb 1, 2024
Details
- NPI
- 1003679200
- Entity type
- Organization (NPI-2)
- Legal business name
- Active Injury Rehab, LLC
- Organization subpart
- No
- Enumeration date
- Feb 1, 2024
- Certification date
- Feb 1, 2024
- Last updated
- Feb 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | – | – | Yes |
| 171100000X | Acupuncturist | – | – | |
| 225700000X | Massage Therapist | – | – |
Other names
- Cascade Spine & Injury Center (Doing Business As)
Practice location
5253 Ne Sandy BlvdPortland, OR 97213-2562
Phone 503-766-4881
Mailing address
1605 Ne 51st AvePortland, OR 97213-2703
Phone 503-440-7470
Authorized official
Keenan Borgardt
Owner
5034407470
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