Provider Demographics
NPI:1427371699
Name:HUMMEL CHIROPRACTIC CENTER PROFESSIONAL CORP
Entity Type:Organization
Organization Name:HUMMEL CHIROPRACTIC CENTER PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-739-3119
Mailing Address - Street 1:5055 N HARBOR DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2302
Mailing Address - Country:US
Mailing Address - Phone:619-523-9355
Mailing Address - Fax:
Practice Address - Street 1:5055 N HARBOR DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-2302
Practice Address - Country:US
Practice Address - Phone:619-523-9355
Practice Address - Fax:619-523-1544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31061111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty