Provider Demographics
NPI:1649206970
Name:WATSON CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:WATSON CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCN, DACBN, QME
Authorized Official - Phone:310-305-9697
Mailing Address - Street 1:12304 ANETA ST
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-5916
Mailing Address - Country:US
Mailing Address - Phone:310-305-9697
Mailing Address - Fax:310-305-9706
Practice Address - Street 1:12304 ANETA ST
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-5916
Practice Address - Country:US
Practice Address - Phone:310-305-9697
Practice Address - Fax:310-305-9706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21161111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty