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General NPI Number Information
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NPI Number | 1134209240
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Entity Type | Organization
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Legal Business Name | PTAK CHIROPRACTIC INC
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 11545 WEST OLYMPIC BLVD SUITE B
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City | LOS ANGELES
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State | CA
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Zip | 90064
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Country | US
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Telephone | 310-473-7991
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Fax | 310-473-7921
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Provider Business Mailing Address
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Address Line | 11545 WEST OLYMPIC BLVD SUITE B
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City | LOS ANGELES
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State | CA
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Zip | 90064
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Country | US
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Telephone | 310-473-7991
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Fax | 310-473-7921
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR CFO
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Name | MS. PATRICIA MAE PTAK
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Credential |
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Telephone | 310-473-7991
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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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