Provider Demographics
NPI:1629711163
Name:BODY RESTORATION, POWERED BY BLOCH WELLNESS O.C. CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:BODY RESTORATION, POWERED BY BLOCH WELLNESS O.C. CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BLOCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-326-8404
Mailing Address - Street 1:6324 E PACIFIC COAST HWY STE C
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-4841
Mailing Address - Country:US
Mailing Address - Phone:562-493-5600
Mailing Address - Fax:562-855-3477
Practice Address - Street 1:351 HOSPITAL RD STE 7
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3504
Practice Address - Country:US
Practice Address - Phone:657-531-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLOCH CHIROPRACTIC WELLNESS AND SPORTS MEDICINE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty