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General NPI Number Information
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NPI Number | 1275814634
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Entity Type | Organization
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Legal Business Name | PIERSON FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 08/30/2011
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 22411 ANTONIO PKWY SUITE C 215
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2803
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Country | US
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Telephone | 949-888-3627
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Fax |
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Provider Business Mailing Address
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Address Line | 22411 ANTONIO PKWY SUITE C 215
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2803
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Country | US
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Telephone | 949-888-3627
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL TODD PIERSON
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Credential | D.C.
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Telephone | 949-888-3627
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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 | DC27149
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License Number State | CA
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