Provider Demographics
NPI:1285018309
Name:REED CHIROPRACTIC & WELLNESS CENTER A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:REED CHIROPRACTIC & WELLNESS CENTER A PROFESSIONAL CORPORATION
Other - Org Name:ADVANCE 2 HEALTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DR./ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-437-4371
Mailing Address - Street 1:4207 DEL REY AVE.
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292
Mailing Address - Country:US
Mailing Address - Phone:310-437-4371
Mailing Address - Fax:310-827-3409
Practice Address - Street 1:4207 DEL REY AVE.
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292
Practice Address - Country:US
Practice Address - Phone:310-437-4371
Practice Address - Fax:310-827-3409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty