Provider Demographics
NPI:1558923698
Name:WEAVER CHIROPRACTIC WELLNESS
Entity Type:Organization
Organization Name:WEAVER CHIROPRACTIC WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:YUKA
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-228-9253
Mailing Address - Street 1:3151 AIRWAY AVE STE F205
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4621
Mailing Address - Country:US
Mailing Address - Phone:949-416-5429
Mailing Address - Fax:949-299-0015
Practice Address - Street 1:3151 AIRWAY AVE STE F205
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4621
Practice Address - Country:US
Practice Address - Phone:949-416-5429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-28
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty