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General NPI Number Information
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NPI Number | 1174760169
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Entity Type | Organization
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Legal Business Name | TAKAO NAKAGAWA CHIROPRACTIC CORP
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 01/23/2009
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Provider Practice Location Address
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Address Line | 411 NORTH CENTRAL AVE SUITE 325
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City | GLENDALE
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State | CA
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Zip | 91203-2055
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Country | US
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Telephone | 818-243-4353
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Fax | 818-240-5245
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Provider Business Mailing Address
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Address Line | 411 NORTH CENTRAL AVE #325
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City | GLENDALE
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State | CA
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Zip | 91203-2055
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Country | US
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Telephone | 818-243-4353
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Fax | 818-240-5245
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Authorized Official
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Title or Position | PRESICENT
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Name | MR. MARK MICHIO ADACHI
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Credential | D.C.
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Telephone | 818-243-4353
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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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