Provider Demographics
NPI:1518931088
Name:SYCAMORE CHIROPRACTIC CENTER INC.
Entity Type:Organization
Organization Name:SYCAMORE CHIROPRACTIC CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-598-1021
Mailing Address - Street 1:750 SYCAMORE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-7912
Mailing Address - Country:US
Mailing Address - Phone:760-598-1021
Mailing Address - Fax:760-598-5584
Practice Address - Street 1:750 SYCAMORE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-7912
Practice Address - Country:US
Practice Address - Phone:760-598-1021
Practice Address - Fax:760-598-5584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18744111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty