Provider Demographics
NPI:1295206928
Name:WELBORN CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:WELBORN CHIROPRACTIC CORPORATION
Other - Org Name:THE HEALTHY SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHARINA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:WELBORN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-872-1120
Mailing Address - Street 1:8700 AUBURN FOLSOM RD STE 300
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-8501
Mailing Address - Country:US
Mailing Address - Phone:916-872-1120
Mailing Address - Fax:916-872-1125
Practice Address - Street 1:8700 AUBURN FOLSOM RD STE 300
Practice Address - Street 2:
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95746-8501
Practice Address - Country:US
Practice Address - Phone:916-872-1120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1174507701OtherIRS