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General NPI Number Information
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NPI Number | 1073698759
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Entity Type | Organization
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Legal Business Name | NEELEY CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 12925 EL CAMINO REAL SUITE J24
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City | SAN DIEGO
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State | CA
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Zip | 92130-1893
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Country | US
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Telephone | 858-755-0808
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Fax | 858-755-7290
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Provider Business Mailing Address
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Address Line | 12925 EL CAMINO REAL SUITE J24
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City | SAN DIEGO
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State | CA
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Zip | 92130-1893
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Country | US
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Telephone | 858-755-0808
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Fax | 858-755-7290
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Authorized Official
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Title or Position | BILLING DIRECTOR
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Name | MS. KORBY J MILLER
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Credential |
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Telephone | 702-475-8050
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC22098
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License Number State | CA
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