Provider Demographics
NPI:1841998226
Name:HEWITT KINESIS CHIROPRACTIC INC.
Entity type:Organization
Organization Name:HEWITT KINESIS CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-508-5109
Mailing Address - Street 1:3662 KATELLA AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-6402
Mailing Address - Country:US
Mailing Address - Phone:562-508-5109
Mailing Address - Fax:562-508-4257
Practice Address - Street 1:3662 KATELLA AVE STE 205
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-6402
Practice Address - Country:US
Practice Address - Phone:562-508-5109
Practice Address - Fax:562-508-4257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty