Provider Demographics
NPI:1659521755
Name:MORRISON VON BUELOW CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:MORRISON VON BUELOW CHIROPRACTIC INC.
Other - Org Name:SAN DIEGO HEALTH & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:VON BUELOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-279-7222
Mailing Address - Street 1:4829 CONVOY ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1610
Mailing Address - Country:US
Mailing Address - Phone:858-279-7228
Mailing Address - Fax:
Practice Address - Street 1:4829 CONVOY ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1610
Practice Address - Country:US
Practice Address - Phone:858-279-7228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28548111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty