Ponderosa Family Chiropractic

NPI #1811222193 in Sisters, Oregon

Provider Information

NPI Number: 1811222193
Entity Type: Organization
Organization Name: Ponderosa Family Chiropractic
Primary Specialty: Chiropractor
Enumeration Date: Oct 5, 2009
Last Updated: Oct 5, 2009

Practice Location

Address: 1011 DESPERADO TRAIL
Address 2: STE 202
City: Sisters
State: Oregon
ZIP Code: 97759
Phone: (541) 588-6200

Authorized Official

Name: DR. ANTHONY L GREEN, D.C.
Title: CHIROPRACTOR, OWNER
Phone: (541) 588-6200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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