Provider Demographics
NPI:1942442470
Name:RENFRO CHIROPRACTIC ROBERT S RENFRO
Entity Type:Organization
Organization Name:RENFRO CHIROPRACTIC ROBERT S RENFRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:RENFRO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-526-9355
Mailing Address - Street 1:206 N EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1621
Mailing Address - Country:US
Mailing Address - Phone:714-526-9355
Mailing Address - Fax:714-526-9350
Practice Address - Street 1:206 N EUCLID ST
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1621
Practice Address - Country:US
Practice Address - Phone:714-526-9355
Practice Address - Fax:714-526-9350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21483111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty