Organization · NPI-2

Active Motion Spine & Rehab LLC

Chiropractor · Gresham, OR

NPI number1164073631
StatusActive
Last updated in NPPESSep 25, 2019

Details

NPI
1164073631
Entity type
Organization (NPI-2)
Legal business name
Active Motion Spine & Rehab LLC
Organization subpart
No
Enumeration date
Sep 25, 2019
Last updated
Sep 25, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor––Yes

Other names

  • Active Motion Spine & Rehab (Doing Business As)

Practice location

1304 Nw Civic Dr
Gresham, OR 97030-5569

Phone 503-512-1040 · Fax 503-662-7334

Mailing address

1304 Nw Civic Dr
Gresham, OR 97030-5569

Phone 503-512-1040 · Fax 503-662-7334

Authorized official

Aaron Montgomery
Owner/Clinic Director
5035121040

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