Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 27 3262 | OR |
NPI | 1316987720 |
---|---|
Provider Name | Dr. John Charles Foland |
First Address | Portland, OR 97232-2342 |
Second Address | Portland, OR 97232-2342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 04/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U96798 | (02) | OR |