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General NPI Number Information
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NPI Number | 1114252152
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Entity Type | Organization
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Legal Business Name | CLINE CHIROPRACTIC CARE
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 10/08/2009
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Provider Practice Location Address
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Address Line | 1021 S MAIN ST
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City | CORONA
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State | CA
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Zip | 92882-4446
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Country | US
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Telephone | 951-279-2339
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Fax | 951-279-1307
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Provider Business Mailing Address
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Address Line | 1021 S MAIN ST
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City | CORONA
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State | CA
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Zip | 92882-4446
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Country | US
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Telephone | 951-279-2339
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Fax | 951-279-1307
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. JEFFERY J. CLINE
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Credential | D.C.
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Telephone | 951-279-2339
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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 | DC15891
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License Number State | CA
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