Provider Demographics
NPI:1174845630
Name:ANDREW SPECHT CHIROPRACTIC PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ANDREW SPECHT CHIROPRACTIC PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:W
Authorized Official - Last Name:SPECHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-632-0098
Mailing Address - Street 1:230 2ND ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3275
Mailing Address - Country:US
Mailing Address - Phone:760-632-0098
Mailing Address - Fax:760-632-8157
Practice Address - Street 1:230 2ND ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3275
Practice Address - Country:US
Practice Address - Phone:760-632-0098
Practice Address - Fax:760-632-8157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18963111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty