Healthcare Provider Details

I. General information

NPI: 1164594693
Provider Name (Legal Business Name): MICHAEL LEE ABNEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 VISITACION AVE
BRISBANE CA
94005-1560
US

IV. Provider business mailing address

101 VISITACION AVE.
BRISBANE CA
94005
US

V. Phone/Fax

Practice location:
  • Phone: 415-467-3456
  • Fax: 415-467-3530
Mailing address:
  • Phone: 415-467-3456
  • Fax: 415-467-3530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number22565
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: