Provider Demographics
NPI:1033523865
Name:HOWARD B. FOX CHIROPRACTIC SPORTS REHAB
Entity Type:Organization
Organization Name:HOWARD B. FOX CHIROPRACTIC SPORTS REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-489-2920
Mailing Address - Street 1:27131 CALLE ARROYO STE 1702
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-2700
Mailing Address - Country:US
Mailing Address - Phone:949-489-2920
Mailing Address - Fax:949-489-3749
Practice Address - Street 1:27131 CALLE ARROYO STE 1702
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-2700
Practice Address - Country:US
Practice Address - Phone:949-489-2920
Practice Address - Fax:949-489-3749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty