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General NPI Number Information
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NPI Number | 1053686188
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Entity Type | Organization
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Legal Business Name | MICHAEL SPAGNOLI CHIROPRATIC CLINIC A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/22/2012
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 23693 CALABASAS ROAD
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City | CALABASAS
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State | CA
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Zip | 91302
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Country | US
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Telephone | 818-225-5900
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Fax | 818-225-5905
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Provider Business Mailing Address
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Address Line | 23693 CALABASAS ROAD
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City | CALABASAS
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State | CA
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Zip | 91302
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Country | US
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Telephone | 818-225-5900
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Fax | 818-225-5905
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL ANTHONY SPAGNOLI
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Credential | D.C.
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Telephone | 818-225-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | DC17829
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License Number State | CA
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