Provider Demographics
NPI:1265612600
Name:SPIRT, MITCHELL NORMAN (DC)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:NORMAN
Last Name:SPIRT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N SEPULVEDA BLVD
Mailing Address - Street 2:#B
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6704
Mailing Address - Country:US
Mailing Address - Phone:310-418-3223
Mailing Address - Fax:
Practice Address - Street 1:400 N SEPULVEDA BLVD
Practice Address - Street 2:#B
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6704
Practice Address - Country:US
Practice Address - Phone:310-418-3223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor