Provider Demographics
NPI:1225536659
Name:HEALTHWISE CHIROPRACTIC, AN ISSAGHOLYAN CORPORATION
Entity Type:Organization
Organization Name:HEALTHWISE CHIROPRACTIC, AN ISSAGHOLYAN CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSAGHOLYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-551-9700
Mailing Address - Street 1:638 E COLORADO ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1710
Mailing Address - Country:US
Mailing Address - Phone:818-551-9700
Mailing Address - Fax:818-551-9725
Practice Address - Street 1:638 E COLORADO ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1710
Practice Address - Country:US
Practice Address - Phone:818-551-9700
Practice Address - Fax:818-551-9725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31596111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty