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General NPI Number Information
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NPI Number | 1215166046
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Entity Type | Organization
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Legal Business Name | MENLO PARK PAIN RELIEF CENTER
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 1030 CURTIS ST SUITE 203
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City | MENLO PARK
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State | CA
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Zip | 94025-4521
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Country | US
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Telephone | 650-281-8815
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Fax | 650-321-8815
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Provider Business Mailing Address
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Address Line | 1030 CURTIS ST SUITE 203
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City | MENLO PARK
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State | CA
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Zip | 94025-4521
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Country | US
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Telephone | 650-281-8815
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Fax | 650-321-8815
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Authorized Official
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Title or Position | OWNER/CLINIC DIRECTOR
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Name | DR. LEWIS ERWIN CONNOR
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Credential | D.C.
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Telephone | 650-281-8815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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