Provider Demographics
NPI:1134779085
Name:PENINSULA RSI CHIROPRACTIC WELLNESS CENTER, INC
Entity type:Organization
Organization Name:PENINSULA RSI CHIROPRACTIC WELLNESS CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-713-4754
Mailing Address - Street 1:260 MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1733
Mailing Address - Country:US
Mailing Address - Phone:650-599-9868
Mailing Address - Fax:650-599-9068
Practice Address - Street 1:260 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1733
Practice Address - Country:US
Practice Address - Phone:650-599-9868
Practice Address - Fax:650-599-9068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty