Provider Demographics
NPI:1326247958
Name:DOORLY CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:DOORLY CHIROPRACTIC CORPORATION
Other - Org Name:PURE HEALTH CHIROPRACTIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOORLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-883-5882
Mailing Address - Street 1:5348 TOPANGA CANYON BLVD
Mailing Address - Street 2:STE. 203
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1739
Mailing Address - Country:US
Mailing Address - Phone:818-883-5882
Mailing Address - Fax:818-883-8513
Practice Address - Street 1:5348 TOPANGA CANYON BLVD
Practice Address - Street 2:STE. 203
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1739
Practice Address - Country:US
Practice Address - Phone:818-883-5882
Practice Address - Fax:818-883-8513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 30516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty