Provider Demographics
NPI:1629352992
Name:SAN FRANCISCO SPINE PAIN RELIEF CENTER A DENNY CHIROPRACTIC CORP.
Entity Type:Organization
Organization Name:SAN FRANCISCO SPINE PAIN RELIEF CENTER A DENNY CHIROPRACTIC CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-775-9100
Mailing Address - Street 1:569 GEARY ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1681
Mailing Address - Country:US
Mailing Address - Phone:415-775-9100
Mailing Address - Fax:415-775-9104
Practice Address - Street 1:569 GEARY ST STE 202
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1681
Practice Address - Country:US
Practice Address - Phone:415-775-9100
Practice Address - Fax:415-775-9104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28055111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0280550Medicare PIN