Provider Demographics
NPI: | 1952738247 |
---|---|
Name: | REED CHIROPRACTIC & WELLNESS CENTER A PROFESSIONAL CORPORATION |
Entity Type: | Organization |
Organization Name: | REED CHIROPRACTIC & WELLNESS CENTER A PROFESSIONAL CORPORATION |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DAVID |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | REED |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 310-437-4371 |
Mailing Address - Street 1: | 13356 BEACH AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | MARINA DEL REY |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90292-5622 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 310-437-4371 |
Mailing Address - Fax: | 310-306-2948 |
Practice Address - Street 1: | 13356 BEACH AVE |
Practice Address - Street 2: | |
Practice Address - City: | MARINA DEL REY |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90292-5622 |
Practice Address - Country: | US |
Practice Address - Phone: | 310-437-4371 |
Practice Address - Fax: | 310-306-2948 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-10-01 |
Last Update Date: | 2015-11-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |