Provider Demographics
NPI:1275956559
Name:HABSTRITT CHIROPRACTIC
Entity Type:Organization
Organization Name:HABSTRITT CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HABSTRITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-272-2581
Mailing Address - Street 1:1380 GARNET AVE STE D
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3013
Mailing Address - Country:US
Mailing Address - Phone:858-272-2581
Mailing Address - Fax:858-272-9639
Practice Address - Street 1:1380 GARNET AVE STE D
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3013
Practice Address - Country:US
Practice Address - Phone:858-272-2581
Practice Address - Fax:858-272-9639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-28376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty