Provider Demographics
NPI:1154075984
Name:SAVAGE CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:SAVAGE CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HANSALAK
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-854-5581
Mailing Address - Street 1:34 BOX CANYON RD
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-1038
Mailing Address - Country:US
Mailing Address - Phone:818-854-5581
Mailing Address - Fax:
Practice Address - Street 1:4766 PARK GRANADA STE 114
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3348
Practice Address - Country:US
Practice Address - Phone:818-225-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty