Provider Demographics
NPI:1114205879
Name:INVIVO NATURAL HEALTH CENTER
Entity Type:Organization
Organization Name:INVIVO NATURAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NERY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-986-5565
Mailing Address - Street 1:17203 VENTURA BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4051
Mailing Address - Country:US
Mailing Address - Phone:818-986-5565
Mailing Address - Fax:818-986-3365
Practice Address - Street 1:17203 VENTURA BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4051
Practice Address - Country:US
Practice Address - Phone:818-986-5565
Practice Address - Fax:818-986-3365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty