NPI 1164073631 · live from the CMS NPI Registry
Active Motion Spine & Rehab LLC
Chiropractor in Gresham, OR. National Provider Identifier 1164073631, active.
NPI record
| NPI | 1164073631 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor 111N00000X |
| Practice location | 1304 Nw Civic Dr, Gresham, OR 97030 |
| Practice phone | 503-512-1040 |
| Enumerated | September 25, 2019 |
| Last updated | September 25, 2019 |
| Authorized official | Aaron Montgomery, Owner/Clinic Director |
| Other names | Active Motion Spine & Rehab |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor primary | 111N00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.