Provider Demographics
NPI:1053686188
Name:MICHAEL SPAGNOLI CHIROPRATIC CLINIC A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MICHAEL SPAGNOLI CHIROPRATIC CLINIC A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SPAGNOLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-225-5900
Mailing Address - Street 1:23693 CALABASAS ROAD
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302
Mailing Address - Country:US
Mailing Address - Phone:818-225-5900
Mailing Address - Fax:818-225-5905
Practice Address - Street 1:23693 CALABASAS ROAD
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302
Practice Address - Country:US
Practice Address - Phone:818-225-5900
Practice Address - Fax:818-225-5905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17829111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty