Provider Demographics
NPI:1790911725
Name:KAMETZ CHIROPRACTIC
Entity Type:Organization
Organization Name:KAMETZ CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:KAMETZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-357-4462
Mailing Address - Street 1:1111 N BRAND BLVD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-3070
Mailing Address - Country:US
Mailing Address - Phone:818-243-6206
Mailing Address - Fax:818-243-2908
Practice Address - Street 1:1111 N BRAND BLVD
Practice Address - Street 2:SUITE 402
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-3070
Practice Address - Country:US
Practice Address - Phone:818-243-6206
Practice Address - Fax:818-243-2908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31280111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty