Doctor Name: | DR. MICHAEL JAY VISSERS |
NPI Number: | 1093843302 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 20436 |
Business Practice Address: | 130 Sw 2nd Ave Ste 101 Canby, OR - 970134156 |
Business Phone Number: | 5032633033 |
Business Fax Number: | 5032633023 |
Mailing Address: | 2030 N Vine St, CANBY |
State: | OR |
Postal Code: | 970132571 |
Phone Number: | 5032638053 |
Fax Number: | |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 09/28/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 20436 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |