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General NPI Number Information
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NPI Number | 1114183662
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Entity Type | Organization
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Legal Business Name | CHANGARIS CHIROPRACTIC WELLNESS & VITALITY CENTER
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 435 CENTER ST
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City | YUBA CITY
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State | CA
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Zip | 95991-4520
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Country | US
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Telephone | 530-673-9140
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Fax |
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Provider Business Mailing Address
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Address Line | 435 CENTER ST
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City | YUBA CITY
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State | CA
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Zip | 95991-4520
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PETE J CHANGARIS
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Credential | DC
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Telephone | 530-673-9140
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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 | DC13482
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License Number State | CA
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