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General NPI Number Information
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NPI Number | 1093358608
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Entity Type | Organization
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Legal Business Name | CANTRELL CHIROPRACTIC INC.
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Dates
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Enumeration Date | 10/26/2019
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Last Update Date | 10/26/2019
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Provider Practice Location Address
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Address Line | 2819 CROW CANYON RD STE 213
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City | SAN RAMON
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State | CA
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Zip | 94583-1657
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Country | US
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Telephone | 925-854-2786
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Fax | 925-848-3900
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Provider Business Mailing Address
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Address Line | 2819 CROW CANYON RD STE 213
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City | SAN RAMON
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State | CA
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Zip | 94583-1657
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Country | US
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Telephone | 925-854-2786
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Fax | 925-848-3900
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANGELA L CANTRELL
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Credential | DC
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Telephone | 925-854-2786
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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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