Provider Demographics
NPI:1376926105
Name:LAWSON V SEALEY CHIROPRACTIC PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:LAWSON V SEALEY CHIROPRACTIC PROFESSIONAL CORPORATION
Other - Org Name:OC HEALTHY SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWSON
Authorized Official - Middle Name:V
Authorized Official - Last Name:SEALEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-929-2657
Mailing Address - Street 1:3010 PARK NEWPORT
Mailing Address - Street 2:APT #202
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5855
Mailing Address - Country:US
Mailing Address - Phone:949-929-2657
Mailing Address - Fax:949-851-5901
Practice Address - Street 1:20151 SW BIRCH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1793
Practice Address - Country:US
Practice Address - Phone:949-929-2657
Practice Address - Fax:949-851-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31008111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty