Provider Demographics
NPI:1568906279
Name:JD NEAL PROFESSIONAL CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:JD NEAL PROFESSIONAL CHIROPRACTIC CORPORATION
Other - Org Name:COMPREHENSIVE SPINAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:619-318-3458
Mailing Address - Street 1:9449 BALBOA AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4335
Mailing Address - Country:US
Mailing Address - Phone:858-569-4545
Mailing Address - Fax:858-569-4546
Practice Address - Street 1:9449 BALBOA AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4335
Practice Address - Country:US
Practice Address - Phone:858-569-4545
Practice Address - Fax:858-569-4546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30591111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty