Provider Demographics
NPI:1346796729
Name:THORBURN CHIROPRACTIC & WELLNESS CENTER INC.
Entity Type:Organization
Organization Name:THORBURN CHIROPRACTIC & WELLNESS CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:BEDDARD
Authorized Official - Last Name:THORBURN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, RN
Authorized Official - Phone:818-841-1313
Mailing Address - Street 1:1612 W BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1311
Mailing Address - Country:US
Mailing Address - Phone:818-841-1313
Mailing Address - Fax:818-841-3340
Practice Address - Street 1:1612 W BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1311
Practice Address - Country:US
Practice Address - Phone:818-841-1313
Practice Address - Fax:818-841-3340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-26
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12296261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center