Healthcare Provider Details
I. General information
NPI: 1730629783
Provider Name (Legal Business Name): QTHERAPY CHIROPRACTIC & ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/24/2017
Last Update Date: 02/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9920 PACIFIC HEIGHTS BLVD 150
SAN DIEGO CA
92121-4396
US
IV. Provider business mailing address
9920 PACIFIC HEIGHTS BLVD 150
SAN DIEGO CA
92121-4396
US
V. Phone/Fax
- Phone: 844-424-7189
- Fax:
- Phone: 844-424-7189
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 33044 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
SCOTT
Title or Position: PRESIDENT
Credential: DC
Phone: 844-424-7189