Provider Demographics
NPI:1043739063
Name:JESSICA LEMUS CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:JESSICA LEMUS CHIROPRACTIC CORPORATION
Other - Org Name:SPECTRA REFORMED CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ADALY
Authorized Official - Last Name:LEMUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-448-3499
Mailing Address - Street 1:5553 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-3919
Mailing Address - Country:US
Mailing Address - Phone:310-448-3499
Mailing Address - Fax:
Practice Address - Street 1:5553 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-3919
Practice Address - Country:US
Practice Address - Phone:310-448-3499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center