Provider Demographics
NPI:1760703938
Name:SARTIN FAMILY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:SARTIN FAMILY CHIROPRACTIC INC
Other - Org Name:ABUNDANT LIFE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:909-289-7155
Mailing Address - Street 1:8678 19TH ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-4559
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8678 19TH ST
Practice Address - Street 2:SUITE 130
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91701-4559
Practice Address - Country:US
Practice Address - Phone:909-289-7155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31254111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADV230AOtherPTAN