Provider Demographics
NPI:1023781770
Name:J NELSON CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:J NELSON CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-333-0733
Mailing Address - Street 1:8491 FLETCHER PKWY
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3005
Mailing Address - Country:US
Mailing Address - Phone:619-333-0733
Mailing Address - Fax:619-828-6558
Practice Address - Street 1:8491 FLETCHER PKWY
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3005
Practice Address - Country:US
Practice Address - Phone:619-333-0733
Practice Address - Fax:619-828-6558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-28
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty