Healthcare Provider Details

I. General information

NPI: 1023767324
Provider Name (Legal Business Name): JORDAN LEAL ZIEGLER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9676 CAMPO RD STE B
SPRING VALLEY CA
91977-1251
US

IV. Provider business mailing address

PO BOX 3265
RANCHO SANTA FE CA
92067-3265
US

V. Phone/Fax

Practice location:
  • Phone: 619-465-9700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC36293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: