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General NPI Number Information
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NPI Number | 1033243696
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Entity Type | Organization
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Legal Business Name | KEVIN F PRIESTLEY CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 3 CORPORATE PLAZA DR SUITE 200
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7932
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Country | US
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Telephone | 949-640-7030
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Fax | 949-640-0356
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Provider Business Mailing Address
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Address Line | 3 CORPORATE PLAZA DR SUITE 200
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7932
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Country | US
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Telephone | 949-640-7030
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Fax | 949-640-0356
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Authorized Official
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Title or Position | OWNER
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Name | KEVIN F PRIESTLEY
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Credential | DC
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Telephone | 949-640-7030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC13648
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License Number State | CA
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