Provider Demographics
NPI:1447431184
Name:CAVELARIS, SPIROS NICK (DC)
Entity Type:Individual
Prefix:
First Name:SPIROS
Middle Name:NICK
Last Name:CAVELARIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24335 VICTORY BLVD
Mailing Address - Street 2:24335 VICTORY BLVD, #D
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-2849
Mailing Address - Country:US
Mailing Address - Phone:818-703-0965
Mailing Address - Fax:818-703-9589
Practice Address - Street 1:24335 VICTORY BLVD
Practice Address - Street 2:24335 VICTORY BLVD, #D
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2849
Practice Address - Country:US
Practice Address - Phone:818-703-0965
Practice Address - Fax:818-703-9589
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23222111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation