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General NPI Number Information
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NPI Number | 1164099180
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Entity Type | Organization
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Legal Business Name | VELLA CHIROPRACTIC CORP
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 72171 HIGHWAY 111 STE 102A
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City | PALM DESERT
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State | CA
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Zip | 92260-2781
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Country | US
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Telephone | 760-636-1540
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Fax | 760-565-5243
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Provider Business Mailing Address
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Address Line | 72171 HIGHWAY 111 STE 102A
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City | PALM DESERT
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State | CA
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Zip | 92260-2781
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Country | US
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Telephone | 760-636-1540
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Fax | 760-565-5243
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Authorized Official
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Title or Position | CEO
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Name | SAMUEL VELLA
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Credential | D.C.
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Telephone | 760-636-1540
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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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