Provider Demographics
NPI:1326911447
Name:PIERCE CHIROPRACTIC & SPORTS INJURY CENTER
Entity type:Organization
Organization Name:PIERCE CHIROPRACTIC & SPORTS INJURY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEAU
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-922-1721
Mailing Address - Street 1:1415 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:80592-8858
Mailing Address - Country:US
Mailing Address - Phone:805-922-1721
Mailing Address - Fax:805-928-8582
Practice Address - Street 1:1415 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:80592-8858
Practice Address - Country:US
Practice Address - Phone:805-922-1721
Practice Address - Fax:805-928-8582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty