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General NPI Number Information
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NPI Number | 1083739841
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Entity Type | Organization
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Legal Business Name | SCOTT A DUBRUL, CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 02/16/2018
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Provider Practice Location Address
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Address Line | 1422 MONTEREY ST STE A201
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2954
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Country | US
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Telephone | 805-781-9155
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Fax | 805-781-0104
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Provider Business Mailing Address
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Address Line | 1422 MONTEREY ST STE A201
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2954
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Country | US
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Telephone | 805-781-9155
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Fax | 805-781-0104
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JULIE LYNN DUBRUL
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Credential |
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Telephone | 805-781-9155
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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 | DC22650
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License Number State | CA
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