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General NPI Number Information
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NPI Number | 1043436355
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Entity Type | Organization
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Legal Business Name | AMY B FRIEDMAN CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 165 YORBA ST
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City | TUSTIN
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State | CA
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Zip | 92780-2924
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Country | US
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Telephone | 714-832-8747
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Fax | 866-572-2498
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Provider Business Mailing Address
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Address Line | 165 YORBA ST
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City | TUSTIN
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State | CA
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Zip | 92780-2924
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Country | US
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Telephone | 714-832-8747
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Fax | 866-572-2498
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Authorized Official
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Title or Position | CEO
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Name | DR. AMY BETH FRIEDMAN
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Credential | D.C.
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Telephone | 714-832-8747
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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 | 23449
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License Number State | CA
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