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FULCRUM OSTEOPATHIC LLC NPI 1033857842


NPI Information

NPI: 1033857842
Provider Name: FULCRUM OSTEOPATHIC, LLC
Classification: Neuromusculoskeletal Medicine & OMM - 204D00000X
Entity Type: Organization
Address:
525 NW 2ND ST
CORVALLIS, OR
ZIP 97330
Phone: (541) 250-5994
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FULCRUM OSTEOPATHIC, LLC is a neuromusculoskeletal medicine omm in Corvallis, OR. The provider is the Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. FULCRUM OSTEOPATHIC, LLC NPI is 1033857842. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

525 NW 2ND ST
CORVALLIS, OR
ZIP 97330-487
Phone: (541) 250-5994
Fax: (541) 638-4002

The provider's authorized official is Matthew Patrick Evitts .
The authorized official title is Owner/member and has the following contact phone number (541) 250-5994.

The enumeration date for this NPI number is 5/23/2022 and was last updated on 12/29/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyNo
2204D00000XNeuromusculoskeletal Medicine & OMMYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1287713MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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