Provider Demographics
NPI:1720250533
Name:VESELAK CHIROPRACTIC, CORPORATION
Entity Type:Organization
Organization Name:VESELAK CHIROPRACTIC, CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:VESELAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-482-0723
Mailing Address - Street 1:3801 LAS POSAS RD
Mailing Address - Street 2:#114
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-1427
Mailing Address - Country:US
Mailing Address - Phone:805-482-0723
Mailing Address - Fax:805-482-9749
Practice Address - Street 1:3801 LAS POSAS RD
Practice Address - Street 2:#114
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-1427
Practice Address - Country:US
Practice Address - Phone:805-482-0723
Practice Address - Fax:805-482-9749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15637111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty