| Gregory Oltmann Dc Llc | |
|
12700 Sw North Dakota St Ste 180 Tigard OR 97223-0802 | |
| (503) 716-8281 | |
| (503) 716-8783 |
| Full Name | Gregory Oltmann Dc Llc |
|---|---|
| Speciality | Chiropractor |
| Location | 12700 Sw North Dakota St Ste 180, Tigard, Oregon |
| Authorized Official Name and Position | Gregory Alan Oltmann (CHIROPRACTOR/OWNER) |
| Authorized Official Contact | 5038881314 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Oltmann Dc Llc 12700 Sw North Dakota St Ste 180 Tigard OR 97223-0802 Ph: () - | Gregory Oltmann Dc Llc 12700 Sw North Dakota St Ste 180 Tigard OR 97223-0802 Ph: (503) 716-8281 |
| NPI Number | 1184406738 |
|---|---|
| Provider Enumeration Date | 10/18/2023 |
| Last Update Date | 04/10/2024 |
| Medicare PECOS PAC ID | 6507204237 |
|---|---|
| Medicare Enrollment ID | O20240401002104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184406738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Gregory A Oltmann |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1588907570 PECOS PAC ID: 2365816212 Enrollment ID: I20230316001779 |
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