Organization · Type 2 NPI

Form Chiropractic LLC

Chiropractor · Redmond, OR

NPI number 1104721646 Active

Practice location

213 SW 34th Ln
Redmond, OR 97756-8547

Call (503) 747-8610 Map

Specialties and licenses

TaxonomyCodeLicense
Chiropractor Primary 111N00000XNone listed

Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

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About NPI 1104721646

Form Chiropractic LLC's National Provider Identifier is 1104721646, issued on Oct 13, 2026. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Redmond, OR. The record was last updated on Oct 13, 2026.