Provider Demographics
NPI:1720493786
Name:GIRAGOSIAN WELLNESS CENTER
Entity Type:Organization
Organization Name:GIRAGOSIAN WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTIN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:GIRAGOSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-970-7678
Mailing Address - Street 1:2511 HONOLULU AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1805
Mailing Address - Country:US
Mailing Address - Phone:818-970-7678
Mailing Address - Fax:
Practice Address - Street 1:2511 HONOLULU AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1805
Practice Address - Country:US
Practice Address - Phone:818-970-7678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty