Provider Demographics
NPI:1386369429
Name:100 CHIRO PADILLA TRAN PC LLC
Entity type:Organization
Organization Name:100 CHIRO PADILLA TRAN PC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-507-0938
Mailing Address - Street 1:4025 MERCANTILE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-2518
Mailing Address - Country:US
Mailing Address - Phone:503-459-1526
Mailing Address - Fax:
Practice Address - Street 1:4025 MERCANTILE DR STE 105
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-2518
Practice Address - Country:US
Practice Address - Phone:503-459-1526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty