Provider Demographics
NPI:1285834457
Name:EPENETER CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:EPENETER CHIROPRACTIC, INC.
Other - Org Name:HEALTH WITHIN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN & BOARD MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:EPENETER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-431-0536
Mailing Address - Street 1:7040 AVENIDA ENCINAS STE 101
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-4653
Mailing Address - Country:US
Mailing Address - Phone:760-431-0536
Mailing Address - Fax:760-931-8158
Practice Address - Street 1:7040 AVENIDA ENCINAS STE 101
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-4653
Practice Address - Country:US
Practice Address - Phone:760-431-0536
Practice Address - Fax:760-931-8158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty