Provider Demographics
NPI:1881146991
Name:WEST CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:WEST CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:ZANE
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-688-5545
Mailing Address - Street 1:PO BOX 1294
Mailing Address - Street 2:
Mailing Address - City:BUELLTON
Mailing Address - State:CA
Mailing Address - Zip Code:93427-1294
Mailing Address - Country:US
Mailing Address - Phone:805-688-5545
Mailing Address - Fax:805-688-5676
Practice Address - Street 1:90 W HIGHWAY 246
Practice Address - Street 2:SUITE 1
Practice Address - City:BUELLTON
Practice Address - State:CA
Practice Address - Zip Code:93427-9719
Practice Address - Country:US
Practice Address - Phone:805-688-5545
Practice Address - Fax:805-688-5676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC28761Medicare PIN