Provider Demographics
NPI:1164883971
Name:VITA SANA CHIROPRACTIC INC
Entity Type:Organization
Organization Name:VITA SANA CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTTILE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-823-1473
Mailing Address - Street 1:20241 W VALLEY BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-8746
Mailing Address - Country:US
Mailing Address - Phone:661-823-1473
Mailing Address - Fax:661-823-1475
Practice Address - Street 1:20241 W VALLEY BLVD
Practice Address - Street 2:STE B
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-8746
Practice Address - Country:US
Practice Address - Phone:661-823-1473
Practice Address - Fax:661-823-1475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC022172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty