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General NPI Number Information
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NPI Number | 1154667111
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Entity Type | Organization
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Legal Business Name | MOVEMENT IS YOUR MEDICINE
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Dates
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Enumeration Date | 12/19/2012
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Last Update Date | 12/19/2012
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Provider Practice Location Address
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Address Line | 401 E OCEAN BLVD
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City | LONG BEACH
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State | CA
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Zip | 90802-4965
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Country | US
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Telephone | 562-999-2383
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Fax |
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Provider Business Mailing Address
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Address Line | 6314 E OCEAN BLVD
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City | LONG BEACH
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State | CA
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Zip | 90803-5649
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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 | CEO/CHIROPRACTOR
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Name | DR. NICHOLAS DONALD REIFF
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Credential | DC
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Telephone | 562-999-2383
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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 | 32017
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License Number State | CA
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